Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Radiol. May 28, 2026; 18(5): 119213
Published online May 28, 2026. doi: 10.4329/wjr.v18.i5.119213
Published online May 28, 2026. doi: 10.4329/wjr.v18.i5.119213
Predictive performance of cervical elastography for preterm birth: A head-to-head network meta-analysis
Hui-Ping Zhang, Yu-Qing Zhou, Department of Ultrasound in Obstetrics and Gynecology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
Na Li, School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
Fan Li, Department of Ultrasound, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
Co-first authors: Hui-Ping Zhang and Na Li.
Co-corresponding authors: Fan Li and Yu-Qing Zhou.
Author contributions: Zhang HP and Li N performed data extraction, contributed to data analysis tools, quality assessment, and wrote the manuscript, and they contributed equally to this work as co-first authors; Zhang HP, Li F, and Zhou YQ analyzed the data; Li F and Zhou YQ contributed equally to this work as co-corresponding authors. All authors designed the research study and all authors have read and approved the final manuscript.
Supported by Key Specialty of Changning District, Shanghai, China, No. 20231004.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Yu-Qing Zhou, MD, Professor, Department of Ultrasound in Obstetrics and Gynecology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Shanghai 200336, China. doczhou@qq.com
Received: January 22, 2026
Revised: March 2, 2026
Accepted: April 7, 2026
Published online: May 28, 2026
Processing time: 125 Days and 23 Hours
Revised: March 2, 2026
Accepted: April 7, 2026
Published online: May 28, 2026
Processing time: 125 Days and 23 Hours
Core Tip
Core Tip: Cervical length and anterior cervical angle are widely used to assess preterm birth risk; however, they overlook early biomechanical remodeling. By synthesizing 15 studies, this head-to-head Bayesian network meta-analysis demonstrates that cervical elastography, particularly the hardness ratio, enhances discrimination, and that combined morphologic-biomechanical models achieve the best overall accuracy. These results support the integration of cervical elastography into risk stratification and highlight the need for standardized protocols and thresholds.