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Wang Z, Ma Y, Zhou J, Jiang F, Chen JY, Chen WZ. Comparing the effect of FUAS and myomectomy on the elasticity of myometrium around targeted uterine fibroid. Int J Hyperthermia 2024; 41:2362998. [PMID: 39128847 DOI: 10.1080/02656736.2024.2362998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 05/09/2024] [Accepted: 05/28/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Focused ultrasound ablation surgery (FUAS) has been widely employed to treat patients with uterine fibroid (UF). This study aimed to estimate myometrial stiffness changes in patients who received FUAS for UFs or myomectomy (ME) and compare the recovery of surrounding myometrium between FUAS and ME groups. Our results may provide more evidence for guiding the proper conception timing in patients with UF. METHODS This study enrolled 173 patients from May 2022 to August 2023. Shear wave elastography (SWE) was used to dynamically monitor myometrial elasticity changes in patients before and after surgery. Moreover, our study monitored and analyzed the stiffness changes in the targeted fibroid after FUAS, as well as in the myometrium around after FUAS or ME. RESULTS The stiffness of the myometrium around the resected fibroid was significantly higher than at the preoperative level until 6 months. Conversely, the stiffness of the surrounding myometrium was only temporarily increased 1 day after FUAS. The comparison between FUAS and ME groups regarding the stiffness of the surrounding myometrium showed that nonsignificant differences were detected between the two groups before the treatment. The stiffness of the surrounding myometrium in the ME group was statistically significantly higher than that of the FUAS group 1 day as well as 1, 3, and 6 months after the treatment, respectively. CONCLUSION The FUAS had less impact on the surrounding myometrium than the ME, which may be more conducive to the recovery of myometrial elasticity in patients with UF.
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Affiliation(s)
- Ziyao Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Department of Ultrasound Medicine, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Yan Ma
- Department of Gynecology, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Jia Zhou
- Department of Ultrasound Medicine, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Feng Jiang
- Department of Gynecology, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Jin-Yun Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Wen-Zhi Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
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Jin J, Xia H, Su Y, Qi T, Hong X, Xie Y, Xu J. Correlation Between Postpartum Myometrial Elasticity and Obstetric Complications in Pregnant Women with Gestational Diabetes Mellitus. J Multidiscip Healthc 2023; 16:4139-4147. [PMID: 38143796 PMCID: PMC10749112 DOI: 10.2147/jmdh.s440448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/07/2023] [Indexed: 12/26/2023] Open
Abstract
Objective To investigate postpartum myometrial elasticity in pregnant women with gestational diabetes mellitus (GDM) using shear wave elastography (SWE) and analyze the correlation between myometrial SWE values and obstetric complications. Methods Clinical data of women who gave birth at Affiliated Hospital of Yangzhou University from August 2022 to July 2023 were retrospectively analyzed and divided into two groups based on GDM diagnosis: the GDM group and the healthy control group. SWE was used to measure the elasticity values of the anterior and posterior myometrial walls in both groups. Differences in placental attachment position and SWE values at the placental attachment site were compared between the two groups. Spearman correlation analysis was utilized to evaluate the correlation between SWE values and obstetric complications. Results Glycated hemoglobin (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), fasting plasma glucose (FPG), 2-hour postprandial glucose (2h PG), triglycerides (TG), and total cholesterol (TC) levels were higher in the GDM group than in the healthy control group (P<0.05). There was a statistically significant difference in placental attachment position between the two groups (P<0.05). In both the GDM (17.52±0.42 vs 25.29±0.74, P=0.001) and control groups (14.06±5.01 vs 22.20±6.34, P=0.001), mean SWE values were significantly lower for anterior versus posterior placental attachment, and mean SWE values were also significantly higher in the GDM versus control group for both anterior (17.52±0.42 vs 14.06±5.01, P=0.001) and posterior placental attachment (25.29±0.74 vs 22.20±6.34, P=0.001). Spearman correlation analysis showed that postpartum hemorrhage (r=0.632, P=0.017), preeclampsia (r=0.818, P=0.014), premature rupture of membranes (r=0.710, P=0.012), placental abruption (r=0.732, P=0.031), and ketoacidosis (r=0.729, P=0.022) were negatively correlated with average myometrial SWE values in the GDM group (P<0.05). Conclusion SWE values at the placental attachment site were higher in GDM patients than in healthy pregnant women, and myometrial elasticity was positively correlated with obstetric complications.
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Affiliation(s)
- Jing Jin
- Department of Ultrasound, Medical Imaging Center, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225009, People’s Republic of China
| | - Han Xia
- Department of Ultrasound, Medical Imaging Center, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225009, People’s Republic of China
| | - Yanan Su
- Department of Radiology, Baoying County People’s Hospital, Yangzhou, 225800, People’s Republic of China
| | - Tingyue Qi
- Department of Ultrasound, Medical Imaging Center, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225009, People’s Republic of China
| | - Xia Hong
- Department of Gynaecology and Obstetrics, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225009, People’s Republic of China
| | - Yanyan Xie
- Department of Gynaecology and Obstetrics, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225009, People’s Republic of China
| | - Jun Xu
- Department of Ultrasound, Medical Imaging Center, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225009, People’s Republic of China
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Bruzeau AH, Moriau D, Bahans C, Mounayer C, Spampinato G, Guigonis V, Ballouhey Q, Fourcade L. Perineal ultrasound in infants with anteriorly displaced anus: A new decision-making tool for the surgeon? Eur J Radiol 2021; 142:109854. [PMID: 34303148 DOI: 10.1016/j.ejrad.2021.109854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Anteriorly displaced anus (ADA) is defined as anterior displacement of the anus toward the perineum. Early radiologic characterization is a crucial step in guiding the first-line management. OBJECTIVE The objective of this study was to assess the urethra-to-anus distance (UAD) on perineal ultrasound in female infants under the age of 3 months with anteriorly displaced anus and to retrospectively determine a cut-off to guide the indications for surgery. MATERIALS AND METHODS Perineal ultrasound was performed prospectively in female infants under the age of 3 months with determination of the UAD, during screening for congenital hip dislocation. Determinations of the UAD on perineal ultrasound and pelvic MRI were performed for anteriorly displaced anus in girls between 2011 and 2018. RESULTS 230 patients were included, of whom 173 were in the control group, with 52 examinations performed for anteriorly displaced anus and 5 examinations performed for vestibular anus. The mean UAD for infants under the age of 3 months was: 22.9 mm (±1.7) in healthy infants, 21.4 mm (±2.4) in infants with non-operated ADA, 17.5 mm (±1.8) in infants with operated ADA, and 10.8 mm (±1.3) in infants with anorectal malformation (ARM). A statistically significant difference was observed between the control group and the ARM group (p = 0.0001) and between the control group and the operated ADA group (p = 0.0001). The mean UAD for infants over the age of 3 months was: 25.5 mm (±4.1) in infants with non-operated ADA and 26 mm (±3) in infants with operated ADA. CONCLUSION A urethra-to-anus distance of less than 17 mm appears to be a cut-off for anteriorly displaced anus in anorectal malformations.
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Affiliation(s)
- Anne-Hélène Bruzeau
- Limoges University Hospital, Radiology, 2 Avenue Martin Luther King, 87000 Limoges, France
| | - Didier Moriau
- Limoges University Hospital, Radiology, 2 Avenue Martin Luther King, 87000 Limoges, France
| | - Claire Bahans
- Limoges University Hospital, Paediatrics, 8 Avenue Dominique Larrey, 87000 Limoges, France
| | - Charbel Mounayer
- Limoges University Hospital, Radiology, 2 Avenue Martin Luther King, 87000 Limoges, France
| | - Grazia Spampinato
- Limoges University Hospital, Paediatric Surgery, 8 Avenue Dominique Larrey, 87000 Limoges, France
| | - Vincent Guigonis
- Limoges University Hospital, Paediatrics, 8 Avenue Dominique Larrey, 87000 Limoges, France
| | - Quentin Ballouhey
- Limoges University Hospital, Paediatric Surgery, 8 Avenue Dominique Larrey, 87000 Limoges, France.
| | - Laurent Fourcade
- Limoges University Hospital, Paediatric Surgery, 8 Avenue Dominique Larrey, 87000 Limoges, France
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New model for predicting preterm delivery during the second trimester of pregnancy. Sci Rep 2017; 7:11294. [PMID: 28900162 PMCID: PMC5595960 DOI: 10.1038/s41598-017-11286-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/17/2017] [Indexed: 12/22/2022] Open
Abstract
In this study, a new model for predicting preterm delivery (PD) was proposed. The primary model was constructed using ten selected variables, as previously defined in seventeen different studies. The ability of the model to predict PD was evaluated using the combined measurement from these variables. Therefore, a prospective investigation was performed by enrolling 130 pregnant patients whose gestational ages varied from 17+0 to 28+6 weeks. The patients underwent epidemiological surveys and ultrasonographic measurements of their cervixes, and cervicovaginal fluid and serum were collected during a routine speculum examination performed by the managing gynecologist. The results showed eight significant variables were included in the present analysis, and combination of the positive variables indicated an increased probability of PD in pregnant patients. The accuracy for predicting PD were as follows: one positive – 42.9%; two positives – 75.0%; three positives – 81.8% and four positives – 100.0%. In particular, the combination of ≥2× positives had the best predictive value, with a relatively high sensitivity (82.6%), specificity (88.1%) and accuracy rate (79.2%), and was considered the cut-off point for predicting PD. In conclusion, the new model provides a useful reference for evaluating the risk of PD in clinical cases.
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Yilmaz Dogru H, Albayrak E, Delibas IB, Isguder CK, Ozsoy AZ, Cakmak B, Ozmen Z, Aktas F. Can myometrial elasticity, as determined by elastography at 18-22 weeks of gestation, predict preterm delivery? J Obstet Gynaecol Res 2016; 42:1686-1693. [PMID: 27558070 DOI: 10.1111/jog.13110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 05/11/2016] [Accepted: 06/18/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Hatice Yilmaz Dogru
- Department of Obstetrics and Gynecology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey
| | - Eda Albayrak
- Department of Radiology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey
| | - Ilhan Bahri Delibas
- Department of Obstetrics and Gynecology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey
| | - Cigdem Kunt Isguder
- Department of Obstetrics and Gynecology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey
| | - Asker Zeki Ozsoy
- Department of Obstetrics and Gynecology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey
| | - Bulent Cakmak
- Department of Obstetrics and Gynecology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey
| | - Zafer Ozmen
- Department of Radiology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey
| | - Fatma Aktas
- Department of Radiology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey
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Albayrak E, Dogru HY, Ozmen Z, Altunkas A, Kalayci TO, Inci MF, Server S, Sonmezgoz F, Aktas F, Demir O. Is evaluation of placenta with real-time sonoelastography during the second trimester of pregnancy an effective method for the assessment of spontaneous preterm birth risk? Clin Imaging 2016; 40:926-30. [PMID: 27183142 DOI: 10.1016/j.clinimag.2016.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 04/08/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study is to investigate the effectiveness of placental strain ratio (SR) values measured by real-time sonoelastography (SE) in the second trimester in the prediction of spontaneous preterm birth (sPTB). METHODS This study included 70 pregnant women who applied to our clinic for routine second-trimester screening. Placental SR measurements were performed with the SE method. Two different SR measurements were performed by taking two different tissues as references. The SR value measured when taking the rectus abdominis muscle as a reference was termed the muscle-to-placenta strain ratio (MPSR), while the SR value measured when taking subcutaneous tissue as a reference was termed the fat-to-placenta strain ratio (FPSR). Women whose gestational age at birth was less than 37 weeks 0 days were accepted as sPTB. The association between gestational age at birth and MPSR and FPSR was investigated. Receiver operating characteristics analysis was used to calculate the sensitivity and specificity of the elastographic outcomes. RESULTS There was a low-level negative correlation between MPSR and gestational age at birth (r=-0.300, P=.012) and there was a moderate-level negative correlation between FPSR and gestational age at birth (r=-0.513, P<.001). The multivariate linear regression analysis showed that the FPSR (β=0.609, P=.002) was the significant predictor for the sPTB. CONCLUSIONS Our data indicate that the FPSR value measured with real-time SE in the second trimester of pregnancy may be effective in the prediction of sPTB.
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Affiliation(s)
- Eda Albayrak
- Department of Radiology, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey.
| | - Hatice Yılmaz Dogru
- Department of Obstetrics and Gynecology, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey.
| | - Zafer Ozmen
- Department of Radiology, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey.
| | - Ayşegül Altunkas
- Department of Radiology, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey.
| | - Tugce Ozlem Kalayci
- Department of Radiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
| | - Mehmet Fatih Inci
- Department of Radiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
| | - Sadık Server
- Department of Radiology, Istanbul Bilim University, Medical Faculty, Şişli Florance Nightingale Hospital, Istanbul, Turkey.
| | - Fitnet Sonmezgoz
- Department of Radiology, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey.
| | - Fatma Aktas
- Department of Radiology, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey.
| | - Osman Demir
- Department of Biostatistics, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey.
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