Jayaprakasan K, Campbell B K, Clewes J S, Johnson I R, Raine-Fenning N J
Nottingham University Research and Treatment Unit in Reproduction (NURTURE), Academic Division of Reproductive Medicine and Surgery, School of Human Development, Queen's Medical Centre, University of Nottingham, UK.
Ultrasound Obstet Gynecol. 2008 Apr;31(4):439-44. doi: 10.1002/uog.5301.
To compare the interobserver reliability of antral follicle counts made using real-time two-dimensional (2D) ultrasound with offline counts made from stored three-dimensional (3D) data and to assess the time required for such counts.
Two observers conducted transvaginal ultrasound examinations in 45 subfertile women in the early follicular phase of the menstrual cycle. Antral follicles were counted using real-time 2D ultrasound and the time taken was recorded. A 3D volume was then acquired from each ovary and stored for subsequent offline analysis using the multiplanar view. The time taken for each step was recorded and the total time was calculated. Intraclass correlation coefficients (ICC) and limits of agreement were used to assess reliability.
There was no difference in the mean antral follicle counts using real-time 2D (16.51 +/- 11.51) and 3D (16.33 +/- 12.13) ultrasound. According to ICCs, there was a significantly higher interobserver reliability for counts made using 3D (mean, 0.992; 95% CI, 0.986-0.996) compared with real-time 2D (mean, 0.961; 95% CI, 0.940-0.977) (P < 0.01) ultrasound. 3D ultrasound was also associated with narrower limits of agreement (-2.7 to + 3.1) than was 2D ultrasound (-6.9 to + 6.4). Whilst the total time taken was significantly longer for the 3D technique (239.3 +/- 71.4 s vs. 103.1 +/- 28.6 s, P < 0.001), the time required for the actual ultrasound examination was significantly less (46.4 +/- 7.4 s vs. 103.1 +/- 28.6 s, P < 0.001).
3D ultrasound significantly improves the interobserver reliability of antral follicle counts. While this is at the expense of time overall, the duration of the actual ultrasound examination and patient exposure is significantly reduced using 3D compared with real-time 2D ultrasound.
比较使用实时二维（2D）超声进行的窦卵泡计数与从存储的三维（3D）数据进行的离线计数之间的观察者间可靠性，并评估此类计数所需的时间。
两名观察者对45名处于月经周期卵泡早期的亚生育期妇女进行经阴道超声检查。使用实时2D超声对窦卵泡进行计数并记录所需时间。然后从每个卵巢获取一个3D容积并存储，以便随后使用多平面视图进行离线分析。记录每个步骤所需的时间并计算总时间。使用组内相关系数（ICC）和一致性界限来评估可靠性。
使用实时2D（16.51±11.51）和3D（16.33±12.13）超声进行的平均窦卵泡计数没有差异。根据ICC，与实时2D（平均值，0.961；95%CI，0.94-0.977）相比，使用3D（平均值，0.992；95%CI，0.986-0.996）进行计数时观察者间可靠性显著更高（P<0.01）。与2D超声（-6.9至+6.4）相比，3D超声的一致性界限也更窄（-2.7至+3.1）。虽然3D技术所需的总时间明显更长（239.3±71.4秒对103.1±28.6秒，P<0.001），但实际超声检查所需的时间明显更少（46.4±7.4秒对103.1±28.6秒，P<0.001）。
3D超声显著提高了窦卵泡计数的观察者间可靠性。虽然这总体上是以时间为代价的，但与实时2D超声相比，使用3D时实际超声检查的持续时间和患者暴露时间显著减少。
