孕期与非孕期宫颈组织应变超声弹性成像参数对比研究

doi:10.12117/jccmi.2019.11.008

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摘要目的：探讨宫颈组织应变超声弹性成像评估孕期与非孕期宫颈组织软硬度特点的应用价值。方法：选取2017年11月—2018年10月北京妇产医院产前检查正常的孕妇40例，根据受检孕周分为：孕期组1（20例，孕20~24周），孕期组2（20例，28~34周），同期选取正常已婚未孕育龄期妇女20例作为非孕期组。采用宫颈组织应变超声弹性成像技术测定孕期与非孕期宫颈不同区域弹性应变率：①完整宫颈应变率（CS）；②宫颈管闭合段宫颈内口应变率（CIS）；③宫颈管宫颈外口应变率（ES）；④宫颈管中点周边应变率（CCS）；⑤宫颈前唇应变率（ACS）。正态分布计量资料多组间比较采用单因素方差分析，两两比较采用LSD-t检验；非正态分布计量资料多组间比较采用Kruskal-Wallis秩和检验。结果：各孕期组中CS、ES、CCS均较非孕期组明显增高，但孕期组间无显著差异；孕期组1中ACS分别较非孕期组、孕期组2明显增高；CIS在三组间差异无统计学意义。结论：宫颈组织应变超声弹性成像能相对较客观地反映出妊娠期宫颈组织变化特点，孕34周前宫颈管宫颈内口组织软硬度与非孕期无明显差别，宫颈其余部位组织在孕20周已开始发生软化，由此可为分娩预测、早产监测提供更加有效的临床应用价值。

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	李菁华
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	王晶晶

关键词 ：子宫颈, 孕妇, 超声检查, 多普勒, 彩色

Abstract：Objective: To explore the application value of strain cervical elastography in the characteristics of cervical softness during pregnancy and non-pregnancy. Methods: Forty pregnant women who received prenatal examination in Beijing Obstetrics and Gynecology Hospital from November 2017 to October 2018 were selected and divided into two groups: group 1 (20 cases, 20~24 weeks), group 2(20 cases, 28~34 weeks) and 20 non-pregnant women were included as control. Five cervical elasticity indexes were obtained by strain elastography: entire cervical strain rate(CS); closed internal cervical os strain rate(CIS); external cervical os strain rate(ES); the midpoint of the cervical canal strain rate(CCS); anterior lip of the cervical strain rate(ACS). One-way ANOVA was used in the normal data and LSD-t test was used in the two groups. Kruskal-Wallis test was used in multi-group for the non-normal data. Results: CS, ES and CCS in pregnancy group were significantly higher than those in non-pregnancy group. However, there was no significant difference of those between pregnancy groups. ACS in group 1 was significantly higher than group 2 and non-pregnancy group. Especially, CIS indicated no significant difference among the three groups. Conclusion: Cervical strain elastography may objectively show the characteristics of cervical tissue that changed during pregnancy. Closed internal cervical os tissue may not be soften before 34 weeks and the rest regions of cervical tissue probably had begun to be soften before 20 weeks of gestation. Those characteristics may give a hand for predicting or monitoring the premature delivery and other cervical lesions.

Key words： Cervix uteri Pregnant women Ultrasonography, Doppler, color

收稿日期: 2018-12-20

PACS:	Ｒ714.14
	Ｒ445.1

基金资助:首都医科大学附属北京妇产医院中青年学科骨干培养专项（FCYY201927）；国家重点研发计划（2016YFC1000104）；北京市医院管理局“登峰”人才培养计划（DFL20151302）。

通讯作者: 吴青青，首都医科大学附属北京妇产医院超声科，100026。E-mail：wuqq2007@163.com

作者简介: 李菁华（1979-），女，北京人，主治医师。E-mail：lijinghua_work@163.com

引用本文:

李菁华，吴青青，张丽娜，梁娜，王晶晶. 孕期与非孕期宫颈组织应变超声弹性成像参数对比研究[J]. 中国临床医学影像杂志, 2019, 30(11): 795-798.
LI Jing-hua, WU Qing-qing, ZHANG Li-na, LIANG Na, WANG Jing-jing. Assessment of cervical softness using strain elastography in pregnant and in non-pregnant women. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(11): 795-798.

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http://www.jccmi.com.cn/CN/10.12117/jccmi.2019.11.008 或 http://www.jccmi.com.cn/CN/Y2019/V30/I11/795

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