Department of Reproductive Medicine, University of California, San Diego Medical Center, San Diego, CA 92103, USA.
J Ultrasound Med. 2011 Apr;30(4):473-9. doi: 10.7863/jum.2011.30.4.473.
The purpose of our study was to evaluate the accuracy and efficacy of using a systematic approach to teach maternal-fetal medicine physicians how to display a diagnostic fetal profile and palate using 3-dimensional ultrasonography (3DUS).
Ten maternal-fetal medicine physicians were randomly assigned to 2 groups, A and B, and instructed on basic principles of 3DUS volume manipulation. Physicians in group A were asked to display the fetal profile in 5 volumes, including 1 fetus with abnormalities. Physicians in Group B were asked to display the fetal profile in the same 5 volumes after detailed instruction. The groups were combined, and detailed instruction was repeated. The physicians were asked to review an additional 5 volumes. In a separate session, the physicians were divided into their respective groups, and a similar exercise was repeated. This time, they were asked to display the fetal palate in 3-orthogonal-plane and parallel-plane images. The time required for manipulation was recorded. Images were reviewed for accuracy and clinical utility by 2 blinded experienced sonologists. Data were analyzed with mixed effects models.
Fetal profile and parallel-plane palate scores were significantly higher in group B (P < .001) compared to group A. There was no difference between groups in displaying the 3-orthogonal-plane image of the palate or after additional training for either group. The mean times for display did not differ between the groups. The time required for evaluation of the abnormal profiles was longer (P = .02) than that for evaluation of the normal profiles.
Detailed instruction in obtaining 3DUS images of fetal profiles and palates improved the image quality obtained by physicians. Teaching physicians in a standardized way may help improve the use of 3DUS in clinical practice.
我们研究的目的是评估采用系统方法教授母胎医学医师使用三维超声（3DUS）显示诊断性胎儿面部和腭部的准确性和效果。
10 名母胎医学医师随机分为 A 组和 B 组，并接受 3DUS 容积操作基本原理的指导。A 组医师被要求在 5 个容积中显示胎儿面部，其中包括 1 个异常胎儿。B 组医师在接受详细指导后被要求在相同的 5 个容积中显示胎儿面部。两组合并，重复详细指导。医师被要求再检查另外 5 个容积。在单独的会议中，医师们被分为各自的组，重复类似的练习。这次，他们被要求在 3 个正交平面和平行平面图像中显示胎儿腭部。记录操作所需的时间。由 2 名经验丰富的盲法超声科医生评估图像的准确性和临床实用性。使用混合效应模型分析数据。
与 A 组相比，B 组的胎儿面部和平行平面腭部评分明显更高（P <.001）。两组在显示 3 个正交平面腭部图像或在两组进行额外培训后，都没有差异。两组显示的平均时间没有差异。评估异常面部所需的时间比评估正常面部的时间长（P =.02）。
详细指导获取胎儿面部和腭部的 3DUS 图像可提高医师获得的图像质量。以标准化的方式教授医师可能有助于提高 3DUS 在临床实践中的应用。
