Scheffer G J, Broekmans F J M, Bancsi L F, Habbema J D F, Looman C W N, Te Velde E R
Department of Reproductive Medicine, Division of Obstetrics, Neonatology and Gynaecology, University Medical Centre, Utrecht, the Netherlands.
Ultrasound Obstet Gynecol. 2002 Sep;20(3):270-5. doi: 10.1046/j.1469-0705.2002.00787.x.
To assess the intra- and interobserver reproducibilities in addition to the between-method reliability of antral follicle counts using two (2D)- and three (3D)-dimensional transvaginal sonography (TVS).
Two groups of women with regular menstrual cycles were studied. One group consisted of healthy volunteers with proven fertility and the other group consisted of patients visiting the general infertility clinic. In each woman, 2D or 3D TVS was performed in the early follicular phase (day 2, 3 or 4) of the menstrual cycle to measure the number of antral follicles (2-10 mm).
Intraobserver reproducibility was calculated from follicle counts using 3D TVS in 41 women. The intraclass correlation coefficient was 0.99 and the 95% coverage interval of the difference (CID) was -3.2 to +3.2. Interobserver reproducibility was assessed from both 2D (n = 37) and 3D (n = 49) TVS-based follicle counts. An interclass correlation coefficient of 0.98 was found for both methods. The 95% CID was -5.0 to +4.1 for 2D and -5.6 to +5.7 for 3D measurements. The latter CID appeared to increase in the higher range of counts. Finally, the degree of agreement between 2D and 3D TVS counts (n = 76) was characterized by a 95% CID of -5.3 to +8.3. This coverage interval widened when higher numbers of follicles were counted. With the exception of the between-method analysis, kappa values indicated overall that follicle counts will hardly change from one category to another when repeatedly carried out.
Determination of antral follicle numbers by both 2D and 3D TVS is adequate with regard to the intra- and interobserver reproducibility. The between-method reproducibility of follicle counts measured both by 2D and 3D ultrasound is moderate. When higher follicle counts are observed both interobserver and between-method reproducibilities tend to decline. If used in categorical classifications, ultrasound-based follicle counts appear to have a high level of agreement between and within observers.
使用二维（2D）和三维（3D）经阴道超声（TVS）评估窦卵泡计数的观察者内和观察者间的可重复性以及不同方法之间的可靠性。
对两组月经周期规律的女性进行研究。一组由生育能力已得到证实的健康志愿者组成，另一组由前往普通不孕不育诊所就诊的患者组成。对每位女性在月经周期的卵泡早期（第2、3或4天）进行2D或3D TVS检查，以测量窦卵泡（直径2 - 10毫米）的数量。
对41名女性使用3D TVS进行卵泡计数计算观察者内可重复性。组内相关系数为0.99，差异的95%覆盖区间（CID）为 - 3.2至 + 3.2。通过基于2D（n = 37）和3D（n = 49）TVS的卵泡计数评估观察者间可重复性。两种方法的组间相关系数均为0.98。2D测量的95% CID为 - 5.0至 + 4.1，3D测量的95% CID为 - 5.6至 + 5.7。后者的CID在较高计数范围内似乎有所增加。最后，2D和3D TVS计数（n = 76）之间的一致性程度以95% CID为 - 5.3至 + 8.3为特征。当计数的卵泡数量较多时，这个覆盖区间会变宽。除了不同方法之间的分析外，kappa值总体表明，重复进行时卵泡计数几乎不会从一个类别变为另一个类别。
就观察者内和观察者间的可重复性而言，2D和3D TVS测定窦卵泡数量是足够的。2D和3D超声测量的卵泡计数的不同方法之间的可重复性中等。当观察到较高的卵泡计数时，观察者间和不同方法之间的可重复性往往会下降。如果用于分类，基于超声的卵泡计数在观察者之间和观察者内部似乎具有高度一致性。
