Department of Obstetrics and Gynecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
Ultrasound Obstet Gynecol. 2010 May;35(5):566-71. doi: 10.1002/uog.7600.
OBJECTIVE: To compare the reproducibility, accuracy and time required for fetal biometric measurements using two-dimensional (2D) and three-dimensional (3D) ultrasonography by an inexperienced operator. METHODS: Fifty consecutive fetuses were evaluated at a gestational age of 17-34 weeks. For every fetus measurements-including biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL)-were made by an inexperienced operator using 2D ultrasound and then saved 3D volumes. As a control, measurements were also made by an experienced operator using 2D ultrasonography alone. Each fetal biometric parameter was measured twice by each operator. All images were assessed by two experienced reviewers, blinded to the operator's identity, using a scoring system based on objective evaluation criteria. RESULTS: The interobserver, intraobserver and inter- method variability for 2D ultrasonography by the experienced operator (2D-exp), and 2D and 3D ultrasonography by the inexperienced operator (2D-inexp and 3D-inexp) was small (all intraclass correlation coefficients > or = 0.991). A non-significantly higher proportion of fetal biometric measurements by 3D-inexp than 2D-inexp were within 1 mm of the measurements by 2D-exp. There were no differences in the mean image quality scores of fetal biometry between 2D-exp and 2D-inexp, 2D-exp and 3D-inexp. However, the quality score of AC images obtained by 3D-inexp was greater than that obtained by 2D-inexp (5.5 vs. 5.3, P = 0.018). The mean time required to measure BPD, HC, AC and FL was less for 3D-inexp than for 2D-inexp (67.2 vs. 97.0 s, 64.6 vs. 97.0 s, 60.1 vs. 81.5 s and 65.5 vs. 95.1 s, respectively; all P < 0.001), but was significantly greater than for 2D-exp, with corresponding figures of 24.3, 24.3, 27.9 and 27.2 s. CONCLUSION: Fetal biometric measurements obtained by an inexperienced operator using both 2D and 3D ultrasound were reproducible and showed good agreement with those obtained by an experienced operator. The use of 3D ultrasound by an inexperienced operator allows faster measurements to be made than by 2D ultrasound and also seems to facilitate the acquisition of higher-quality images for measurement of AC.
目的：比较经验不足的操作者使用二维（2D）和三维（3D）超声进行胎儿生物测量的可重复性、准确性和所需时间。
方法：对 50 例妊娠 17-34 周的胎儿进行评估。对每例胎儿，经验不足的操作者均使用 2D 超声进行双项径（BPD）、头围（HC）、腹围（AC）和股骨长（FL）测量，并保存 3D 容积。作为对照，经验丰富的操作者也单独使用 2D 超声进行测量。每位操作者均对每位胎儿进行两次生物测量。所有图像均由两位具有丰富经验的审阅者进行评估，他们对操作者的身份不了解，使用基于客观评估标准的评分系统进行评估。
结果：经验丰富的操作者（2D-exp）使用 2D 超声和经验不足的操作者（2D-inexp 和 3D-inexp）使用 2D 和 3D 超声的观察者间、观察者内和方法间变异性均较小（所有组内相关系数均>或=0.991）。3D-inexp 比 2D-inexp 获得的胎儿生物测量值中，有更大比例的测量值与 2D-exp 测量值相差在 1mm 以内。2D-exp 和 2D-inexp、2D-exp 和 3D-inexp 之间的胎儿生物测量图像质量评分均值无差异。然而，3D-inexp 获得的 AC 图像质量评分大于 2D-inexp（5.5 比 5.3，P=0.018）。3D-inexp 测量 BPD、HC、AC 和 FL 的平均时间少于 2D-inexp（分别为 67.2 秒比 97.0 秒、64.6 秒比 97.0 秒、60.1 秒比 81.5 秒和 65.5 秒比 95.1 秒；所有 P<0.001），但明显长于 2D-exp，分别为 24.3、24.3、27.9 和 27.2 秒。
结论：经验不足的操作者使用 2D 和 3D 超声进行的胎儿生物测量可重复性好，与经验丰富的操作者获得的结果具有良好的一致性。经验不足的操作者使用 3D 超声进行测量比使用 2D 超声更快，并且似乎还更有利于获得用于 AC 测量的高质量图像。
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