Objective-To explore the clinical value of real-time shear wave ultrasonic elastography in diagnosing the depth of infiltrating muscularis of endometrial cancer.Methods-Seventy-one patients with stage I endometrial cancer infiltrating the myometrium and 37 patients with normal physical examination were enrolled and divided into three groups: endometrial cancer superficial muscle infiltration group, endometrial cancer deep muscle infiltration group, and normal control group. After completing 2-dimensional ultrasound examination, each patient switched to the real-time shear wave elastography mode to measure the elasticity values Emax, Emean, and Esd.Results-For control group, comparison of elastic modulus values between superficial muscular layer near the intimal surface and the deep muscular layer near the serosa surface showed no difference (P > 0.05). For endometrial cancer superficial muscular infiltration group, significant difference was found regarding the elastic modulus values of infiltrated muscular layer and uninfiltrated muscular layer (Emax and Emean) without difference for Esd (P > 0.05). A significant difference of elastic modulus was observed between control group and deep myometrial infiltration group (P < 0.05) without difference of Emean or Emax but with difference of Esd. The accuracy in diagnosing muscular layer infiltration was 78.9% for Emax cutoff and 82.5% for Emean cutoff. The rate of using Emax ≥32.22 kPa or Emean ≥27.54 kPa as the ultrasound standard for diagnosing myometrium infiltration was 92.9%. The accuracy for the diagnosis of muscular layer infiltration was 96.1% for Emax cutoff, 94.1% for Emean cutoff and 86.3% for Esd cutoff.Conclusion-Real-time shear wave elastography is helpful to determine the depth of infiltrating myometrium of endometrial cancer.

Background To explore the value of transvaginal real-time shear wave elastography (SWE) in the diagnosis of endometrial lesions. Methods A total of 140 female patients with endometrial lesions, confirmed by pathological results, were divided into three groups: 45 cases of endometrial polyps, 29 cases of endometrial hyperplasia and 66 cases of endometrial cancer. A total of 100 cases of normal endometrium were used as the control group, including 52 cases in the proliferative stage and 48 cases in the secretory stage. Transvaginal real-time shear wave elastography was performed in all four groups. Results Emean, Emax and Esd were expressed as the average standard deviation. Among the control group, the results were 26.24±9.74, 38.09±9.18, and 4.25±2.73 kPa, respectively, in the proliferative endometrium cases and 12.51±7.46, 27.22±11.32, 4.40±2.52 kPa, respectively, in the secretory endometrium cases. Among the experimental group, the result was 15.68±8.18, 27.28±10.28 and 3.62±1.81 kPa respectively in the endometrial polyps cases; 21.20 ± 12.57, 36.32 ± 15.04, and 5.09 ±3.93 kPa in the endometrial hyperplasia cases; 49.36±25.51, 86.66±42.27 and 14.86±10.63 kPa in the endometrial cancer cases. The difference was statistically significant (P <0.05). When the truncation values of Emean, Emax and Esd were 28.50, 52.45 and 9.05 kPa, respectively, to distinguish between normal endometrium and endometrial cancer, Emax has the highest diagnostic value. Conclusion Real-time SWE technology might be used as an auxiliary method in the diagnosis and differential diagnosis of endometrial cancer. More quantitative indicators are conducive to diagnosis.

Objective: To evaluate whether the combined measurement of pelvic organ mobility and levator hiatus area improves the sensitivity of transperineal ultrasound (the index test) for diagnosing pelvic organ prolapse (POP).Methods: We retrospectively recruited women who had been examined in a tertiary gynecological center for symptoms of lower urinary tract incontinence and/or POP between January 2017 and June 2018. We excluded patients who had undergone hysterectomy previously or those who had received corrective surgery. All subjects underwent a standardized interview, POP quantification (POP-Q) examination (a reference standard for patients and controls), and ultrasound measurements of the levator hiatus area at rest (rHA), on contraction (cHA), and on Valsalva (vHA). We also determined the mobility of the bladder neck (BNM), cervix (CM), and rectum ampulla (RAM). Receiver operating characteristic (ROC) curve analyses were performed to determine cut-off values for diagnosis. Diagnostic performance was assessed by sensitivity, specificity, and area under curve (AUC).Results: A total of 343 women were eligible for analysis, including 247 POP patients (stage 2–3 by POP-Q) and 96 controls. Compared with controls, POP cases had significantly higher values for rHA, vHA, cHA, BNM, CM, and RAM. Each parameter was identified as a significant discriminator for POP and controls, as determined by ROC curve analysis, although the cut-off value varied slightly between different parameters. The combination of rHA, vHA, and cHA (with any HA that was ≥ the cut-off) improved the sensitivity from 64–89 to 89–93%. The combination of pelvic organ mobility with rHA, vHA, and cHA, further increased the sensitivity from 89–93 to 95–97%.Conclusion: The combination of levator hiatus area and pelvic organ mobility improved the sensitivity of transperineal ultrasound in the diagnosis of POP, whether used as a frontline test to assist POP-Q grading or to monitor the effect of pelvic floor exercise programs.

Objectives-The present study aims to evaluate the clinical application values of ultrasound real-time shear wave elastography (SWE) in the diagnosis and differential diagnosis of cervical cancer (CC).Methods-A total of 285 married female patients were screened and divided into three groups according to the results of the pathological examination and the cervical ThinPrep cytologic test: 1) the CC group (n = 94); 2) the cervical intraepithelial neoplasia (CIN) group (n = 91); and 3) the normal control group (n = 100). The maximum Young's modulus (Emax), mean Young's modulus (Emean), minimum Young's modulus (Emin), and Young's modulus stability (Esd) in each group were measured and statistically analyzed.Results-There were no statistically significant differences in Emax, Emean, Emin, and Esd values between the anterior and posterior cervical walls, premenopausal and postmenopausal women, and nonparturient and parturient women in the normal control group. The Emax, Emean, Emin, and Esd values in the CIN group showed no statistically significant differences in different periods when compared with the control group. The differences between the normal control group and the CC group were statistically significant; the CC group showed no statistically significant differences in Emax, Emean, Emin, and Esd values at different clinical stages and in different pathological types. The cutoff value of Emax for CC diagnosis, which was of the highest accuracy (89.7%), was 43.48 kpa. Conclusion-Ultrasound real-time SWE can be applied to CC diagnosis.