采用统一操作方法E-Cervix技术评估孕中晚期宫颈弹性

Unified operating method of E-Cervix technology for evaluation on cervical elasticity in the second and third trimester of pregnancy

目的评价以统一操作方法E-Cervix技术测量孕中晚期孕妇宫颈弹性参数的一致性。方法将160名孕中晚期孕妇分为宫颈内口闭合组(n=80)及开放组(n=80),于其中各随机选取40名作为统一操作亚组,其余40名为非统一操作亚组。由2名超声医师对各亚组孕妇行E-Cervix检查,测量宫颈弹性参数,包括弹性对比指数(ECI)、硬度比值(HR)、宫颈内口应变(IOS)、宫颈外口应变(EOS)、宫颈内外口应变比(IOS/EOS)及宫颈长度(CL)。采用组内相关系数(ICC)评价观察者内测量结果的一致性;如操作后每名医师测得各亚组内全部参数的ICC均≥0.6,则以Bland-Altman法评价观察者间测量参数的一致性。结果非统一操作时,每名医师测得每组部分参数ICC<0.6(P均<0.05);采用统一方法操作,每名医师测得参数的ICC均>0.8(P均<0.05)。统一操作后,Bland-Altman分析显示观察者间测量参数的一致性良好,各参数差值中95%~100%位于95%一致性界限内,差值的均值、回归方程的截距与斜率均无统计学意义(P均>0.05)。结论以统一方法行孕中晚期E-Cervix检查,所测宫颈弹性参数结果的一致性较高。

Objective To observe the consistency of unified operating method E-Cervix technology for evaluation on cervical elasticity of pregnancy women in the second and third trimester.Methods A total of 160 pregnant women in the second and third trimester of pregnancy were enrolled and divided into closed internal cervix orifice group(n=80)or open group(n=80).Pregnant women in each group were randomly further divided into unified operating subgroup or non-uniform operating subgroup(each n=40).E-Cervix examination was performed by 2 sonographers to measure cervical elasticity parameters,including elastic contrast index(ECI),hardness ratio(HR),internal os strain(IOS),external or strain(EOS),internal and external strain ratio(IOS/EOS)and cervical length(CL).The intra-class correlation coefficient(ICC)was used to evaluate the intra-observer consistency of the measurement results.Under the condition of ICC of all parameters measured by each sonographer≥0.6,the Bland-Altman method was used to analyze the inter-observer consistency of the measurement results of the above parameters.Results Using non-uniform operating method,the ICC of some parameters measured by each sonographer were<0.6(all P<0.05),whereas using unified operating method,the ICC of all parameters measured by each sonographer were>0.8(all P<0.05).Bland-Altman method analysis exhibited good inter-observer consistency of the measured parameters using unified operating method.There were 95%-100%points of the differences of parameters within 95%limits of agreement.The mean of the differences and the intercept and slope of the regression equation were not statistically different(all P>0.05).Conclusion Using unified operating method of E-Cervix might obtain good consistency of measurement results of cervical elasticity parameters of pregnancy women in the second and third trimester.