Ultrasound Unit, Department of Obstetrics and Gynecology, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain.
Prenat Diagn. 2013 Apr;33(4):384-90. doi: 10.1002/pd.4079. Epub 2013 Mar 14.
This study aimed to evaluate the application of two quality assurance methods to the ductus venosus pulsatility index (DVPI), as a first-trimester aneuploidy marker, including retrospective assessment of distribution parameters and cumulative sum (CUSUM) plots.
The DVPI was measured in 14 444 singleton fetuses at 11+0 to 13+6 weeks in two Fetal Medicine centers during a 4-year period. Sonologist-specific quality assurance distribution parameters, previously described for nuchal translucency, were assessed: the median multiples of the median (MoM), the logarithmic standard deviation of DVPI MoMs and the weekly DVPI percent decrease. Quality assurance results were compared between median MoMs and MoM-based CUSUM plots.
When sonologist-specific DVPI distribution parameters were retrospectively applied for quality assurance, a 1.0 median MoM, a 0.1 median logarithmic standard deviation and a 3.4 median weekly DVPI drop percentage were observed. CUSUM plots showed good agreement with 0.9-1.1 MoMs range for median MoM, in the assessment of sonologist-specific performances.
Retrospective and prospective DVPI quality assurance methods appear to be applicable to DVPI at 11+0 to 13+6 weeks. Its use should be encouraged if DVPI is to be added to first-trimester Down syndrome or cardiac defects screening.
本研究旨在评估两种质量保证方法在静脉导管搏动指数（DVPI）中的应用，作为一项 11+0 至 13+6 周的唐氏综合征或心脏缺陷筛查的早期妊娠非整倍体标志物，包括对分布参数和累积和（CUSUM）图的回顾性评估。
在两个胎儿医学中心，在 4 年期间，对 14444 例 11+0 至 13+6 周的单胎胎儿进行了静脉导管搏动指数的测量。评估了先前描述的用于颈项透明层的特定超声医生的质量保证分布参数：中位数倍数（MoM）的中位数、静脉导管搏动指数 MoM 的对数标准差和每周静脉导管搏动指数下降百分比。将质量保证结果与中值 MoM 与基于 MoM 的 CUSUM 图进行比较。
当回顾性应用特定于超声医生的静脉导管搏动指数分布参数进行质量保证时，观察到 1.0 的中值 MoM、0.1 的中值对数标准差和 3.4 的中值每周静脉导管搏动指数下降百分比。CUSUM 图在评估特定于超声医生的性能时，与 0.9-1.1 MoM 的中值 MoM 范围具有良好的一致性。
回顾性和前瞻性的静脉导管搏动指数质量保证方法似乎适用于 11+0 至 13+6 周的静脉导管搏动指数。如果要将静脉导管搏动指数添加到 11+0 至 13+6 周的唐氏综合征或心脏缺陷筛查中，应鼓励使用。
