Estimation of shear wave speed in the human uterine cervix

Objectives To explore spatial variability within the cervix and the sensitivity of shear wave speed (SWS) to assess softness/stiffness differences in ripened (softened) vs unripened tissue. Methods We obtained SWS estimates from hysterectomy specimens (n=22), a subset of which were ripened (n=13). Multiple measurements were made longitudinally along the cervical canal on both the anterior and posterior sides of the cervix. Statistical tests of differences in the proximal vs distal, anterior vs posterior and ripened vs unripened cervix were performed with individual two-sample t-tests and a linear mixed model. Results Estimates of SWS increase monotonically from distal to proximal longitudinally along the cervix, they vary in the anterior compared to the posterior cervix and they are significantly different in ripened vs unripened cervical tissue. Specifically, the mid position SWS estimates for the unripened group were 3.45 +/- 0.95 m/s (anterior; mean +/- SD) and 3.56 +/- 0.92 m/s (posterior), and 2.11 +/- 0.45 m/s (anterior) and 2.68 +/- 0.57 m/s (posterior) for the ripened group (P<0.001). Conclusions We propose that SWS estimation may be a valuable research and, ultimately, diagnostic tool for objective quantification of cervical stiffness/softness. Copyright (C) 2013 ISUOG. Published by John Wiley & Sons Ltd.