Tedesco Giselle Darahem, Bussamra Luiz Cláudio de Silva, Araujo Júnior Edward, Britto Ingrid Schwach Werneck, Nardozza Luciano Marcondes Machado, Moron Antonio Fernandes, Aoki Tsutomu
Department of Gynecology and Obstetrics, Medical Science College of Santa Casa of São Paulo (FCMSCSP), São Paulo, Brazil.
Fetal Diagn Ther. 2009;25(4):385-91. doi: 10.1159/000236151. Epub 2009 Sep 30.
To establish reference values for fetal renal volume by three-dimensional sonography using the VOCAL (Virtual Organ Computer-Aided Analysis) method.
This prospective longitudinal study involved 57 healthy pregnant women who were examined between 24 and 34 weeks of pregnancy. Each fetal kidney was evaluated separately using the VOCAL method with a 30 degree rotation angle. For each gestational age, the following measures were obtained for the right and left kidneys: mean, standard deviation, minimum and maximum values, and the 5th, 10th, 25th, 50th, 75th and 90th percentiles. Polynomial regression models were constructed to assess the relationship between renal volume and gestational age, adjusted by the determination coefficient (R(2)). The Wilcoxon test was used to evaluate the concordance between the right and left renal volumes. Bland-Altman graphs were used to assess intra- and inter-observer variability.
The right renal volume increased from 4.5 +/- 1.3 cm(3) at 24 weeks to 12.1 +/- 1.5 cm(3) at 34 weeks. The left renal volume increased from 4.6 +/- 0.8 cm(3) at 24 weeks to 11.9 +/- 1.1 cm(3) at 34 weeks. There was a strong correlation between both the right and left renal volumes and gestational age (R(2) = 0.975 and 0.970, respectively). There were no significant differences between the right and left renal volumes. The mean difference between repeated measures by the same examiner was -0.07 cm(3) (-0.88 to 0.75) for the right kidney and -0.21 cm(3) (-0.95 to 0.75) for the left kidney. The mean difference between repeated measures obtained by two different examiners was -0.07 cm(3) (-1.25 to 1.12) for the right kidney and 0 cm(3) (-1.53 to 1.53) for the left kidney.
Reference values were generated for fetal renal volume assessed by three-dimensional ultrasonography using the VOCAL method.
采用VOCAL（虚拟器官计算机辅助分析）方法通过三维超声检查建立胎儿肾体积的参考值。
这项前瞻性纵向研究纳入了57名健康孕妇，她们在妊娠24至34周期间接受检查。使用VOCAL方法以30度旋转角度分别评估每个胎儿的肾脏。对于每个孕周，获取左右肾脏的以下测量值：均值、标准差、最小值和最大值，以及第5、10、25、50、75和90百分位数。构建多项式回归模型以评估肾体积与孕周之间的关系，并通过决定系数（R²）进行校正。采用Wilcoxon检验评估左右肾体积之间的一致性。使用Bland-Altman图评估观察者内和观察者间的变异性。
右肾体积从24周时的4.5±1.3 cm³增加到34周时的12.1±1.5 cm³。左肾体积从24周时的4.6±0.8 cm³增加到34周时的11.9±1.1 cm³。左右肾体积与孕周之间均存在强相关性（R²分别为0.975和0.970）。左右肾体积之间无显著差异。同一检查者重复测量的右肾平均差值为-0.07 cm³（-0.88至0.75），左肾为-0.21 cm³（-0.95至0.75）。两名不同检查者重复测量的右肾平均差值为-0.07 cm³（-1.25至1.12），左肾为0 cm³（-1.53至1.53）。
采用VOCAL方法通过三维超声检查得出了胎儿肾体积的参考值。
