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胎儿脑室扩大的产前诊断:胎儿脑部超声检查与磁共振成像的一致性

Prenatal diagnosis of fetal ventriculomegaly: Agreement between fetal brain ultrasonography and MR imaging.

作者信息

Perlman S, Shashar D, Hoffmann C, Yosef O B, Achiron R, Katorza E

机构信息

From the Antenatal Diagnostic Unit (S.P., D.S., R.A., E.K.)

From the Antenatal Diagnostic Unit (S.P., D.S., R.A., E.K.).

出版信息

AJNR Am J Neuroradiol. 2014 Jun;35(6):1214-8. doi: 10.3174/ajnr.A3839. Epub 2014 Jan 16.

Abstract

BACKGROUND AND PURPOSE

Accurate measurement of the lateral ventricles is of paramount importance in prenatal diagnosis. Possible conflicting classifications caused by their measurement in different sectional planes by sonography and MR imaging are frequently raised. The objective of our study was to evaluate the agreement between ultrasonography and MR imaging in the measurement of the lateral ventricle diameter in the customary sectional planes for each technique.

MATERIALS AND METHODS

Measurement of both lateral ventricles was performed prospectively in 162 fetuses from 21 to 40 weeks of gestational age referred for evaluation due to increased risk for cerebral pathology. The mean gestational age for evaluation was 32 weeks. The measurements were performed in the customary plane for each technique: axial plane for sonography and coronal plane for MR imaging.

RESULTS

The 2 techniques yielded results in substantial agreement by using intraclass correlation and κ coefficient score tests. When we assessed the clinical cutoff of 10 mm, the κ score was 0.94 for the narrower ventricle and 0.84 for the wider ventricle, expressing almost perfect agreement. The Bland-Altman plot did not show any trend regarding the actual width of the ventricle, gestational week, or interval between tests. Findings were independent for fetal position, sex, and indication for examination.

CONCLUSIONS

Our study indicates excellent agreement between fetal brain ultrasonography and MR imaging as to the diagnosis of fetal ventriculomegaly in the customarily used sectional planes of each technique.

摘要

背景与目的

在产前诊断中,准确测量侧脑室至关重要。超声检查和磁共振成像(MR成像)在不同断面测量侧脑室时可能导致分类冲突的问题屡见不鲜。我们研究的目的是评估超声检查和MR成像在各自常用断面测量侧脑室直径时的一致性。

材料与方法

前瞻性地对162例孕21至40周因脑病变风险增加而转诊评估的胎儿双侧侧脑室进行测量。评估时的平均孕周为32周。测量在每种技术的常用平面进行:超声检查为轴面,MR成像为冠状面。

结果

通过组内相关系数和κ系数评分检验,这两种技术的结果具有高度一致性。当我们评估10mm的临床临界值时,较窄侧脑室的κ评分为0.94,较宽侧脑室的κ评分为0.84,显示出几乎完美的一致性。Bland-Altman图未显示出与脑室实际宽度、孕周或检查间隔有关的任何趋势。研究结果与胎儿体位、性别及检查指征无关。

结论

我们的研究表明,在每种技术常用的断面中,胎儿脑超声检查和MR成像在诊断胎儿脑室扩大方面具有高度一致性。

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