Feasibility of 3D Ultrasound Strain Analysis in the Non-Pregnant Uterus

Uterine mechanical behavior in the form of uterine contraction plays a key role in reproduction. Irregular patterns of uterine contractility associate with dysfunctions of the uterus. Current quantitative assessments of uterine motion primarily rely on two-dimensional transvaginal ultrasound (2D TVUS). However, 2D TVUS offers a limited view of the uterus, and the quantification is further affected by out-of-plane (OOP) motion problems. In this study, our objective is to compare the efficacy of three-dimensional (3D) TVUS against 2D TVUS in detecting uterine contraction propagation. To achieve this, we utilized 3D speckle tracking and radial strain analysis to track uterine movements and deformation. Following this, we proposed a dedicated propagation detection method to quantify and visualize the 3D propagation patterns. Both 2D and 3D ultrasound scans were performed on a healthy volunteer during the late follicular phase of the menstrual cycle and a patient undergoing in-vitro fertilization (IVF). Our preliminary findings indicate that 3D TVUS detects more complete and consistent propagation compared to 2D TVUS, suggesting the potential utility of 3D TVUS for quantitatively measuring uterine contraction and enhancing our understanding of its underlying mechanisms.