Cabezas López Elena, Martínez-Payo Cristina, Engels Calvo Virginia, San Frutos Llorente Luis, Pérez-Medina Tirso
Hospital Puerta de Hierro-Majadahonda, Madrid, Spain.
Hospital Puerta de Hierro-Majadahonda, Madrid, Spain.
Eur J Obstet Gynecol Reprod Biol. 2016 Jun;201:156-60. doi: 10.1016/j.ejogrb.2016.03.034. Epub 2016 Apr 14.
The aim of this study was to assess intra and interobserver reproducibility of placental volume and vascularization during the first trimester of pregnancy studied by three dimensional ultrasonography and angio power Doppler.
This is a prospective study in 69 singleton pregnancies. Once the bi-dimensional protocol study was carried out, we performed a 3D-US (three-dimensional ultrasonography) of the placenta by abdominal ultrasonography. The Virtual Organ Computer-Aided Analysis program was used to evaluate the placental volume (PV), the placental quotient (PQ: placental volume/crown-rump length) and the vascular indices (vascularization index VI, flow index FI and vascularization-flow index VFI). The intraobserver and interobserver variability were respectively expressed as an intraclass correlation coefficient (Intra-CC) and interclass correlation coefficient (inter-CC).
Intraobserver correlation for PV was excellent with an Intra-CC of 0.97 while an Inter-CC of 0.71 demonstrated less agreement between observers. In the same way, PQ showed better intraobserver than interobserver correlation, with an Intra-CC of 0.97 and an inter-CC of 0.67. The analyzed vascular indices had both excellent intraobserver and interobserver correlation coefficients, with values of 0.98 and 0.96 for VI, 0.93 and 0.89 for FI and 0.97 and 0.95 for VFI, respectively.
Our study demonstrate an excellent intra and inter-observer reproducibility for vascular indices and a good reproducibility of the evaluated Doppler indices with intra-CC higher than 0.90. PV and PQ were also reproducible most of all within the same observer. As a conclusion, first trimester tridimensional sonography is a reproducible tool for the systematic study of placental vascularization.
本研究旨在评估通过三维超声和血管能量多普勒研究妊娠早期胎盘体积和血管形成的观察者内及观察者间的可重复性。
这是一项针对69例单胎妊娠的前瞻性研究。在完成二维方案研究后，我们通过腹部超声对胎盘进行三维超声（3D-US）检查。使用虚拟器官计算机辅助分析程序评估胎盘体积（PV）、胎盘商数（PQ：胎盘体积/头臀长）和血管指数（血管形成指数VI、血流指数FI和血管形成-血流指数VFI）。观察者内和观察者间的变异性分别用组内相关系数（Intra-CC）和组间相关系数（inter-CC）表示。
PV的观察者内相关性极佳，Intra-CC为0.97，而观察者间的Inter-CC为0.71，表明观察者之间的一致性较差。同样，PQ的观察者内相关性优于观察者间相关性，Intra-CC为0.97，inter-CC为0.67。分析的血管指数的观察者内和观察者间相关系数均极佳，VI的值分别为0.98和0.96，FI为0.93和0.89，VFI为0.97和0.95。
我们的研究表明血管指数具有极佳的观察者内和观察者间可重复性，评估的多普勒指数具有良好的可重复性，Intra-CC高于0.90。PV和PQ在同一观察者内也大多具有可重复性。总之，妊娠早期三维超声检查是系统研究胎盘血管形成的一种可重复的工具。
