Departments of Gynecology and Obstetrics, University Hospital of Lausanne CHUV, Lausanne, Switzerland.
Fetal Diagn Ther. 2013;34(2):96-102. doi: 10.1159/000351135. Epub 2013 Jun 18.
A standardized three-dimensional ultrasonographic (3DUS) protocol is described that allows fetal face reconstruction. Ability to identify cleft lip with 3DUS using this protocol was assessed by operators with minimal 3DUS experience.
260 stored volumes of fetal face were analyzed using a standardized protocol by operators with different levels of competence in 3DUS. The outcomes studied were: (1) the performance of post-processing 3D face volumes for the detection of facial clefts; (2) the ability of a resident with minimal 3DUS experience to reconstruct the acquired facial volumes, and (3) the time needed to reconstruct each plane to allow proper diagnosis of a cleft.
The three orthogonal planes of the fetal face (axial, sagittal and coronal) were adequately reconstructed with similar performance when acquired by a maternal-fetal medicine specialist or by residents with minimal experience (72 vs. 76%, p = 0.629). The learning curve for manipulation of 3DUS volumes of the fetal face corresponds to 30 cases and is independent of the operator's level of experience.
The learning curve for the standardized protocol we describe is short, even for inexperienced sonographers. This technique might decrease the length of anatomy ultrasounds and improve the ability to visualize fetal face anomalies.
本研究描述了一种标准化的三维超声（3DUS）协议，可实现胎儿面部重建。通过具有较少 3DUS 经验的操作人员评估了使用该协议通过 3DUS 识别唇裂的能力。
通过具有不同 3DUS 能力水平的操作人员使用标准化协议对 260 个胎儿面部存储容积进行分析。研究的结果包括：（1）处理 3D 面部容积以检测面部裂隙的性能；（2）具有较少 3DUS 经验的住院医师重建所获取的面部容积的能力；（3）重建每个平面以允许正确诊断裂隙所需的时间。
通过母胎医学专家或具有较少经验的住院医师获取的胎儿面部的三个正交平面（轴向、矢状和冠状）的重建具有相似的性能（72%与 76%，p=0.629）。胎儿面部 3DUS 容积操作的学习曲线对应 30 个病例，与操作人员的经验水平无关。
我们描述的标准化协议的学习曲线较短，即使对于经验不足的超声医师也是如此。该技术可能会缩短解剖超声的长度，并提高可视化胎儿面部异常的能力。
