{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T05:09:32Z","timestamp":1769317772242,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,4,16]],"date-time":"2018-04-16T00:00:00Z","timestamp":1523836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine whether a novel, noninvasive quantitative ultrasound (US) technique can detect differences in proximal and distal cervical tissue echogenicity in women with and without a shortened cervical length (CL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective case\u2010control study of singleton pregnancies at 16 to 26 weeks' gestation in which a transvaginal US examination was performed to measure CL from 2013 to 2015. Initial CLs in cases and controls were less than 2.5\u2009cm and 2.5\u2009cm or greater, respectively. For each US image, a region of interest was selected in the proximal and distal cervical stroma, in both the anterior and posterior cervical lips. The Floyd\u2010Steinberg dithering algorithm transformed grayscale pixels in each region of interest into a binary map. A histogram tabulated the number of black and white pixels, allowing determination of the percent echogenicity. The difference in the percent echogenicity was calculated by subtracting the distal cervical echogenicity (average of anterior and posterior lips) from the proximal cervical echogenicity (average of anterior and posterior lips).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ultrasound images from 177 women were analyzed. There was a difference in the percent echogenicity (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001) when comparing women with a short cervix (mean\u2009\u00b1\u2009SD, 9.8\u2009\u00b1\u200910.1; n\u2009=\u2009102) to women with a normal CL (17.2\u2009\u00b1\u20099.5; n\u2009=\u200975). Differences were attributable to changes in proximal (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.008) rather than distal cervical echogenicity. Regardless of CL, the proximal cervix was more echogenic than the distal cervix.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A quantitative US analysis of cervical tissue can detect differences in echogenicity between the proximal and distal cervix in the second trimester. Proximal cervical echogenicity is lower with CL of less than 2.5\u2009cm compared to a normal CL.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.14647","type":"journal-article","created":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T04:19:56Z","timestamp":1523938796000},"page":"2873-2879","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Quantitative Ultrasound Analysis of Proximal and Distal Cervical Tissue Echogenicity in Premature Cervical Remodeling"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5534-6928","authenticated-orcid":false,"given":"Matthew J.","family":"Blitz","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell Manhasset New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sleiman R.","family":"Ghorayeb","sequence":"additional","affiliation":[{"name":"Department of Radiology North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell Manhasset New York USA"},{"name":"Department of Molecular Medicine North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell Manhasset New York USA"},{"name":"School of Engineering and Applied Sciences Ultrasound Research Laboratory, Hofstra University Hempstead New York USA"},{"name":"Center for Immunology and Inflammation Feinstein Institute for Medical Research, Northwell Health Manhasset New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah L.","family":"Pachtman","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell Manhasset New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Murphy","sequence":"additional","affiliation":[{"name":"School of Engineering and Applied Sciences Ultrasound Research Laboratory, Hofstra University Hempstead New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zara","family":"Rahman","sequence":"additional","affiliation":[{"name":"School of Engineering and Applied Sciences Ultrasound Research Laboratory, Hofstra University Hempstead New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lakha","family":"Prasannan","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell Manhasset New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina P.","family":"Sison","sequence":"additional","affiliation":[{"name":"Department of Radiology North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell Manhasset New York USA"},{"name":"Department of Molecular Medicine North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell Manhasset New York USA"},{"name":"Biostatistics Unit Feinstein Institute for Medical Research, Northwell Health Manhasset New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nidhi","family":"Vohra","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell Manhasset New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burton","family":"Rochelson","sequence":"additional","affiliation":[{"name":"Division of 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Quantitative analysis of the cervical texture by ultrasound in the mid\u2010pregnancy is associated with spontaneous preterm birth [published online ahead of print May 15 2017].Ultrasound Obstet Gynecol. doi:10.1002\/uog.17525.","DOI":"10.1002\/uog.17525"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1159\/000448475"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2011.30.9.1197"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e3182487e96"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2013-0277"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2014-0382"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12555"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a1284"},{"key":"e_1_2_6_31_1","first-page":"909","article-title":"Cervical length screening in patients who have undergone loop electrosurgical excision procedure","volume":"53","author":"Parikh R","year":"2008","journal-title":"J Reprod Med"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjum.14647","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.14647","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jum.14647","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.14647","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T04:59:59Z","timestamp":1694062799000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.14647"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,16]]},"references-count":30,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1002\/jum.14647"],"URL":"https:\/\/doi.org\/10.1002\/jum.14647","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"value":"0278-4297","type":"print"},{"value":"1550-9613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,16]]},"assertion":[{"value":"2018-01-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}