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Background: Endometrial cancer is the most common gynecological cancer among women in developed countries. Sono-elastography is an extended ultrasonographic technique that has been shown to be useful in a wide range of conditions ranging from breast, prostate, and thyroid nodules to chronic liver disease and musculoskeletal conditions. The aim of this study is to compare the sonoelastographic features of endometrial malignancy and normal endometrium. Methods: This case–control observational study was conducted at a single institution. Participants with histologically proven endometrial cancer according to the results from microcurettage or hysteroscopic biopsy and scheduled for total hysterectomy were included as cases, while asymptomatic women scheduled for routine screening ultrasound examination were recruited as controls. Both cases and controls underwent conventional B-mode transvaginal ultrasonography and strain elastography. Demographic, ultrasonographic, and histopathologic findings were analyzed. Results: A total of 29 endometrial cancer patients (cases) and 28 normal females (controls) were included in the analysis. There was no significant difference in the mean age between the two groups, but the mean body weight was significantly higher in the case group ( P < 0.001). The strain ratio and elastographic thickness ratio of the endometrium were statistically significantly different between the case and the control group ( P ≤ 0.05) due to increased endometrial stiffness in cancer patients as compared to the normal group. Conclusion: Our results suggest that endometrial cancer can result in increased stiffness that is detectable by transvaginal sonoelastography. Sonoelastography may serve as an adjunct to conventional ultrasound in evaluating the endometrium of women with abnormal uterine bleeding.

To assess if there are differences in the sonoelastographic features between normal women and patients with endometrial cancer on transvaginal ultrasound.

Objectives:To investigate what are the risk factors for early pregnancy loss (EPL) after in vitro fertilisation-embryo transfer (IVF-ET). Methods: This was a retrospective study in a single reproductive centre. The infertile patients included in this study underwent IVF treatment between June 2016 to December 2017. During this period, 13,977 women were identified with a singleton pregnancy by TVS at day 27-29 after IVF-ET. The gestational sac diameter (GSD), embryonic length (EL), embryonic heart rate (EHR) and YSD and the presence of intrauterine hematoma (IUH) were measured. The clinical characteristics were also collected. The first trimester pregnancy outcome of these women was noted at 12 weeks of gestation. A backward Wald logistic regression model was established to screen the risk factors. Results: 1,926 cases of spontaneous miscarriage ≤ 12 weeks of gestation, which were assigned as EPL and 12,051 women with an ongoing pregnancy for > 12 weeks of gestation. When compared with the ongoing pregnancy group, the MA, infertility duration and transfer cycle were significantly higher, and the day-14 human chorionic gonadotrophin and the endometrium (EM) thickness on transfer day were significantly lower in the EPL group (p < 0.001).Based on the TVS measurements, the GSD (18.5±3.6 vs. 13.2 ± 4.8 mm), EL (3.5 ± 0.9 vs. 1.2 ± 1.6 mm), YSD (3.6 ± 0.4 vs. 2.6 ± 1.5 mm) and EHR (114.5 ± 12.2 vs. 42.4 ± 53.5 bpm) were significantly greater in the ongoing pregnancy group than those in the EPL group (p < 0.001). The incidence of IUH (16.0% vs. 18.8%, P = 0.002) was also markedly higher in the EPL group. MA, GSD, EL, YSD, EHR and EM on transfer day finally entered the logistic model after stepwise screening. The probability of EPL was: exp(z)/(1 + exp(z)), where z = 2.432 + (0.092 × MA) -(0.074 × EM) -(0.114 ×GSD) -(0.245 × EL) -(0.034 × HR) -(0.159 × YSD). Conclusions: The maternal age, gestational sac diameter, embryonic length, yolk sac diameter, heart rate of day 27-29 and endometrium thickness on transfer day were risk factors.