Abstract：
UNASSIGNED: This study aimed to investigate changes in the cervical strain rate (SR), cervical length (CL), and uterine artery blood flow parameters during early pregnancy in women with cervical insufficiency and evaluate the clinical efficacy of these markers for screening of cervical insufficiency in early pregnancy.
UNASSIGNED: This retrospective study in 60 pregnant women with cervical insufficiency and 100 normal pregnant women was conducted between September 2021 and January 2023 and measured ultrasound parameters of the cervix during early pregnancy. The cervical SR, CL, and uterine artery resistance index (RI) were measured in both groups at 11-14 weeks of gestation. Strain elastography represented by the SR was used to assess the hardness of the internal and external cervical openings.
UNASSIGNED: During early pregnancy, the SR at the internal and external cervical openings were significantly higher in the cervical insufficiency group than those in the normal pregnancy group (SR I: 0.19 ± 0.018% vs. 0.16 ± 0.014%; SR E: 0.26 ± 0.028% vs. 0.24 ± 0.025%; p < .001). The CL was significantly shorter in the cervical insufficiency group than that measured in the normal pregnancy group (34.3 ± 2.9 mm vs. 35.2 ± 1.99 mm; p = .036), while cervical blood perfusion was also poorer in the cervical insufficiency group than that in the normal pregnancy group (uterine artery RI: 0.76 ± 0.07 vs. 0.74 ± 0.05; p = .048). Receiver operating characteristic (ROC) curve analysis showed that the optimal critical values for diagnosing cervical insufficiency were 0.17% for SR I, 0.25% for SR E, 33.8 mm for CL, and 0.78 for uterine artery RI. Of these parameters, the ROC curve for SR I had the largest area under the curve [AUC = 0.89 (p < .001)], with the highest sensitivity (78%) and specificity (82%). Multivariate logistic regression analysis demonstrated that the SR at the internal cervical opening (OR 17.47, 95% confidence interval (CI) 5.08-60.08; p < .001) and CL (OR 5.05, 95% CI 1.66-15.32; p = .004) still showed significant differences between the two groups.
UNASSIGNED: Cervical elastography is an effective tool for screening early pregnancy cervical insufficiency. The SR at the internal cervical opening is a valuable indicator for screening cervical insufficiency and has superior clinical efficacy for screening for this condition compared to that of CL and the uterine artery blood flow index.
UNASSIGNED: This retrospective study in 60 pregnant women with cervical insufficiency and 100 normal pregnant women was conducted between September 2021 and January 2023 and measured ultrasound parameters of the cervix during early pregnancy. The cervical SR, CL, and uterine artery resistance index (RI) were measured in both groups at 11-14 weeks of gestation. Strain elastography represented by the SR was used to assess the hardness of the internal and external cervical openings.
UNASSIGNED: During early pregnancy, the SR at the internal and external cervical openings were significantly higher in the cervical insufficiency group than those in the normal pregnancy group (SR I: 0.19 ± 0.018% vs. 0.16 ± 0.014%; SR E: 0.26 ± 0.028% vs. 0.24 ± 0.025%; p < .001). The CL was significantly shorter in the cervical insufficiency group than that measured in the normal pregnancy group (34.3 ± 2.9 mm vs. 35.2 ± 1.99 mm; p = .036), while cervical blood perfusion was also poorer in the cervical insufficiency group than that in the normal pregnancy group (uterine artery RI: 0.76 ± 0.07 vs. 0.74 ± 0.05; p = .048). Receiver operating characteristic (ROC) curve analysis showed that the optimal critical values for diagnosing cervical insufficiency were 0.17% for SR I, 0.25% for SR E, 33.8 mm for CL, and 0.78 for uterine artery RI. Of these parameters, the ROC curve for SR I had the largest area under the curve [AUC = 0.89 (p < .001)], with the highest sensitivity (78%) and specificity (82%). Multivariate logistic regression analysis demonstrated that the SR at the internal cervical opening (OR 17.47, 95% confidence interval (CI) 5.08-60.08; p < .001) and CL (OR 5.05, 95% CI 1.66-15.32; p = .004) still showed significant differences between the two groups.
UNASSIGNED: Cervical elastography is an effective tool for screening early pregnancy cervical insufficiency. The SR at the internal cervical opening is a valuable indicator for screening cervical insufficiency and has superior clinical efficacy for screening for this condition compared to that of CL and the uterine artery blood flow index.
摘要：
■本研究旨在调查宫颈应变率（SR）的变化，宫颈长度（CL），宫颈功能不全妇女孕早期子宫动脉血流参数,并评价这些指标对孕早期宫颈功能不全筛查的临床疗效。
■这项回顾性研究是在2021年9月至2023年1月之间对60名宫颈机能不全的孕妇和100名正常孕妇进行的，并测量了妊娠早期宫颈的超声参数。颈椎SR，CL,在妊娠11-14周时测量两组的子宫动脉阻力指数（RI）。由SR表示的应变弹性成像用于评估内部和外部宫颈开口的硬度。
■在怀孕初期，宫颈机能不全组内、外宫颈开口处的SR明显高于正常妊娠组(SRI:0.19±0.018%vs.0.16±0.014%；SRE：0.26±0.028%vs.0.24±0.025%；p<.001）。宫颈机能不全组的CL明显短于正常妊娠组（34.3±2.9mmvs.35.2±1.99mm;p=.036),而宫颈机能不全组比正常妊娠组的宫颈血液灌注也差（子宫动脉RI：0.76±0.07vs.0.74±0.05；p=.048）。受试者工作特征（ROC）曲线分析表明，SRI诊断宫颈机能不全的最佳临界值为0.17％，SRE为0.25%，CL为33.8mm，子宫动脉RI为0.78。在这些参数中，SRI的ROC曲线具有最大的曲线下面积[AUC=0.89(p<.001)]，具有最高的灵敏度（78％）和特异性（82％）。多因素logistic回归分析显示，宫颈内开口处的SR（OR17.47，95％置信区间（CI）5.08-60.08；p<.001）和CL（OR5.05，95％CI1.66-15.32；p=.004）在两组之间仍显示出显着差异。
■宫颈弹性成像是筛查早孕宫颈机能不全的有效工具。宫颈内开口处的SR是筛查宫颈机能不全的有价值的指标，与CL和子宫动脉血流指数相比，对筛查这种情况具有优越的临床疗效。
■这项回顾性研究是在2021年9月至2023年1月之间对60名宫颈机能不全的孕妇和100名正常孕妇进行的，并测量了妊娠早期宫颈的超声参数。颈椎SR，CL,在妊娠11-14周时测量两组的子宫动脉阻力指数（RI）。由SR表示的应变弹性成像用于评估内部和外部宫颈开口的硬度。
■在怀孕初期，宫颈机能不全组内、外宫颈开口处的SR明显高于正常妊娠组(SRI:0.19±0.018%vs.0.16±0.014%；SRE：0.26±0.028%vs.0.24±0.025%；p<.001）。宫颈机能不全组的CL明显短于正常妊娠组（34.3±2.9mmvs.35.2±1.99mm;p=.036),而宫颈机能不全组比正常妊娠组的宫颈血液灌注也差（子宫动脉RI：0.76±0.07vs.0.74±0.05；p=.048）。受试者工作特征（ROC）曲线分析表明，SRI诊断宫颈机能不全的最佳临界值为0.17％，SRE为0.25%，CL为33.8mm，子宫动脉RI为0.78。在这些参数中，SRI的ROC曲线具有最大的曲线下面积[AUC=0.89(p<.001)]，具有最高的灵敏度（78％）和特异性（82％）。多因素logistic回归分析显示，宫颈内开口处的SR（OR17.47，95％置信区间（CI）5.08-60.08；p<.001）和CL（OR5.05，95％CI1.66-15.32；p=.004）在两组之间仍显示出显着差异。
■宫颈弹性成像是筛查早孕宫颈机能不全的有效工具。宫颈内开口处的SR是筛查宫颈机能不全的有价值的指标，与CL和子宫动脉血流指数相比，对筛查这种情况具有优越的临床疗效。
