Ultraschall Med 2012; 33 - A736
DOI: 10.1055/s-0032-1322729

Reliability of quantitative elastography for cervical stiffness assessment during pregnancy

A Fruscalzo 1, AP Londero 2, C Fröhlich 1, U Möllmann 3, R Schmitz 3
  • 1Frauenklinik, Mathias-Spital Rheine, Germany (current adress: St. Franziskus Hospital, DE Münster)
  • 2Clinic of Obstetrics and Gynecology, University Hospital of Udine, Italy
  • 3Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, University ofMünster, Germany

fruscal@libero.it

Objective:

To evaluate the reliability of quantitative cervical elastography for stiffness assessment during pregnancy.

Methods:

Prospective study conducted among 74 consecutive patients in the 12th and 42th weeks of gestation. The cervical tissue strain (TS) was measured through tissue Doppler imaging (TDI)-based elastography by two independent operators as naturalstrain during a relaxation cycle phase with the 5mm derivative pitch preset. The intraclass correlation coefficient (ICC) agreement and Bland-Altman plots were calculated for the intra- and inter-operator reliability.

Results:

The population features were as follows: gestational age, parity, cervical length, TS respectively of 29.08 (±8.93) weeks, 1 (IQR 1–2), 36.9 (±10.17)mm and 0.54 (±0.19) (mean±SD, median and IQR).

TS significantly correlated with gestational age, cervical length, and parity. Cervical TS measurement showed overall a high intra- and inter-operator reliability: The intra-operator ICC agreement was 0.93 and the interoperator ICC agreement was 0.89 for a single measurement; the inter-operator ICC agreement for the average of two measurements was 0.93.

Conclusions:

The strain measurement was high reliable and significantly correlated with gestational age, cervical length, and parity. The inter-operator reliability slightly improved when considering the mean value of two measurements.

Ultrasonography - elasticity imaging techniques - tissue elastography - tissue Doppler imaging - cervix - pregnancy - reproducibility of results