title: Quantification of cervical elastography: a reproducibility study.
abstract: OBJECTIVE
  To assess a new method for numerical quantification of cervical elastography during pregnancy and to evaluate the repeatability of the measurements.
  
  
  METHODS
  Cervical elastography was carried out twice by a single operator in 112 singleton pregnancies at a median of 21 (range, 12-40) weeks' gestation. In 50 of the cases a second operator performed another elastography measurement. The intraobserver and interobserver repeatability of measurements in different parts of the cervix were assessed using intraclass correlation coefficients with 95% CI and by Bland-Altman analysis.
  
  
  RESULTS
  There were no statistically significant differences in the elastography measurements made by the same and by two different observers in each area measured, except in the area that receives the force of the transducer directly. The distribution of elastographic measurements obtained in different regions of the cervix demonstrated that the external and superior parts were significantly softer than the internal and inferior parts.
  
  
  CONCLUSIONS
  It is possible to provide an objective quantification of elastographic colors in the cervix. The measurements obtained by elastography may be a mere reflection of the force being applied by the transducer to different parts of the cervix. It is too premature to suggest that the measurements of rate-of-change in tissue displacement reflect histological changes that could provide a measure of cervical ripening.
authors.affiliation: Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynaecology, San Cecilio University Hospital (HUSC), Granada, Spain. fsoniamolina@gmail.com
authors.forename: F S
authors.initials: FS
authors.lastname: Molina
authors.forename: L F
authors.initials: LF
authors.lastname: Gómez
authors.forename: J
authors.initials: J
authors.lastname: Florido
authors.forename: M C
authors.initials: MC
authors.lastname: Padilla
authors.forename: K H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D020070:Cervical Ripening; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D047928:Premature Birth / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods; D055815:Young Adult