Viñals F, Muñoz M, Naveas R, Shalper J, Giuliano A
Centro AGB Ultrasonografía, Universidad de Concepción, Concepción, Chile.
Ultrasound Obstet Gynecol. 2005 Nov;26(6):622-7. doi: 10.1002/uog.2606.
To describe the normal appearance and study the biometry of the fetal cerebellar vermis by three-dimensional (3D) volume contrast imaging in the coronal (C-) plane (VCI-C).
A total of 203 normally developed fetuses were examined prospectively at 18-33 weeks' gestation. At the level of the view used to measure the transverse cerebellar diameter (TCD), a VCI-C plane was displayed to examine, using a transabdominal probe, the fetal mid-saggital vermis. The volumes acquired were stored for later review and measurement of the anteroposterior (AP) diameter, craniocaudal (CC) diameter and surface area of the cerebellar vermis. Each dataset was evaluated by two independent observers. Measurements as a function of gestational age (GA), biparietal diameter (BPD), head circumference (HC) and TCD were expressed by regression equations. Interobserver variability was evaluated. Nomograms were produced. In order to validate the use of VCI in fetal biometry, datasets from 57 patients were selected arbitrarily for comparison of their VCI-C measurements with those from mid-sagittal sections of a stored 3D multiplanar examination. Intraclass correlation was used to evaluate the agreement between these measurements.
The mean maternal age was 32 years. We were able to measure mid-sagittal CC diameter, mid-sagittal AP diameter and cerebellar vermis surface area in all fetuses. Interobserver variability analysis showed no significant differences between the two observers (P > 0.05). Measurements of the cerebellar vermis (AP diameter, CC diameter and surface area) correlated linearly with GA, BPD, HC and TCD (r > or = 0.82, P < 0.0001). CC and AP diameters estimated from the mid-sagittal section of the multiplanar measurements were significantly correlated with VCI-C measurements (r = 0.96, P < 0.00001 and r = 0.95, P < 0.00001, respectively).
VCI-C is a valuable tool, allowing intrauterine assessment of the normal appearance of the fetal cerebellar vermis. The nomograms developed in this study should enable accurate evaluation of the cerebellar vermis.
通过三维（3D）容积对比成像在冠状面（C平面，即VCI-C）描述胎儿小脑蚓部的正常表现并研究其生物测量学。
前瞻性地检查了203例孕18 - 33周正常发育的胎儿。在用于测量小脑横径（TCD）的视图水平，使用经腹探头显示VCI-C平面以检查胎儿正中矢状面的蚓部。采集的容积数据存储起来以备后续回顾，并测量小脑蚓部的前后径（AP）、头尾径（CC）和表面积。每个数据集由两名独立观察者进行评估。测量值作为孕周（GA）、双顶径（BPD）、头围（HC）和TCD的函数，用回归方程表示。评估观察者间的变异性。制作了列线图。为了验证VCI在胎儿生物测量中的应用，从57例患者中任意选择数据集，将其VCI-C测量值与存储的3D多平面检查的正中矢状面测量值进行比较。组内相关用于评估这些测量值之间的一致性。
孕妇平均年龄为32岁。我们能够测量所有胎儿的正中矢状面CC径、正中矢状面AP径和小脑蚓部表面积。观察者间变异性分析显示两名观察者之间无显著差异（P > 0.05）。小脑蚓部的测量值（AP径、CC径和表面积）与GA、BPD、HC和TCD呈线性相关（r≥0.82，P < 0.0001）。多平面测量的正中矢状面估计的CC径和AP径与VCI-C测量值显著相关（分别为r = 0.96，P < 0.00001和r = 0.95，P < 0.00001）。
VCI-C是一种有价值的工具，可在子宫内评估胎儿小脑蚓部的正常表现。本研究中制作的列线图应能准确评估小脑蚓部。
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