Assessment of the endometrium by elastography in patients without uterine pathology

Elastography is a complementary technique to B-mode ultrasound that evaluates tissue elasticity (endometrium and myometrium), improving its characterisation and increasing diagnostic specificity. Shear wave elastography quantifies the results in numerical data, which allows increasing the reproducibility of the technique. The objective of this study is to determine if there are elastographic changes at the endometrial level in young women throughout the menstrual cycle. This is a prospective and longitudinal validation study of elastography technique for the evaluation of myometrium and endometrium. All patients, without hormone treatment or IUD, underwent transvaginal ultrasound in 6 phases of the cycle: Early proliferative phase: cycle days 4-7. Middle proliferative phase: cycle days 8-11. Late proliferative: days 11-14. Early luteal: days 15-20 or mid-luteal: days 20-22 or Late luteal: days 23-28 using SAMSUNG ultrasound machine RS85 PRESTIGE. Three quantitative elastographic parameters (velocity m/s, IQR (interquartile range) m/s, and % IQR) were evaluated in three different positions endometrium, posterior myometrium and anterior myometrium. To compare the quantitative values between the different phases of the cycle, repeated measures analysis of variance (ANOVA) was used. A total of 21 patients with a median age of 34 years (IQR 30-39) were included in this study. The mean values (mean+sd) for velocity were 2.93 ± 1.01, 3.94 ± 0.92, 3.85 ± 0.86 in the three respective locations. The mean values observed for IQR/m/s were 0.60 ± 0.27, 0.72 ± 0.34, 0.73 ± 0.32. The following values were observed for % IQR: 21%±8%, 18%±8%, 19%±7%. The only parameter with cycle-related variation was the mean % IQR in the endometrium. Quantitative shear wave elastography is a useful and reproducible technique for the evaluation of the endometrium and can be used to detect elastographic changes throughout the menstrual cycle in young women.