Assessment of uterine cervix by computerized texture analysis

Background Cervical ripening during pregnancy is associated with ultrastruc tural alterations, presumably correlated with structural changes of the ult rasonographic image. Analysing these changes might allow conclusions on cer vical consistence without necessarily performing manual examination. Patients and Methods Ultrasound findings of 112 patients with normal pregna ncy (14th to 41st week of pregnancy) have been compared to those of 57 pati ents admitted because of cervical insufficiency (20th to 35th week). A repr esentative region of interest was analysed using a computer based texture a nalysing system ("Ultra" written in "Interactive Data Language"). 125 param eters derive from various texture algorithms: Ist order gray scale statisti cs, row, slit and area statistics, gradient statistics, coocurrence statist ics. By means of factor and multiple regression analysis those parameters c ould be determined, which contribute significantly to the clinical assessme nt of cervical consistence. Weighting these parameters a so called texture score (TS) and implementing the other parameters of the Bishop-Score (BS) - a texture based cervical score (TBCS) could be established. Results Manual assessment of cervical consistence could be reproduced excel lently by noninvasive texture analysis. TBCS was highly correlated to BS, c orrelation to remaining duration of pregnancy (RDOP) was highly significant for TBCS but insignificant for BS. Conclusions Manual assessment of cervical consistence may be replaced by no ninvasive texture analysis. Using RDOP as target parameter TS and TBCS turn out to be superior to manual assessment and BS respectively. Discussion Computer aided texture analysis of cervical ultrasound imaging p rovides a useful information, which can be obtained easily and might help t o reduce palpatory controls and increase the accuracy of prediction of preg nancy prolongation.