Roy-Lacroix M E, Moretti F, Ferraro Z M, Brosseau L, Clancy J, Fung-Kee-Fung K
Department of Obstetrics, Gynecology and Newborn Care, Division of Maternal-Fetal Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.
Department of Obstetrics and Gynecology, University of Sherbrooke, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.
J Perinatol. 2017 Apr;37(4):380-386. doi: 10.1038/jp.2016.212. Epub 2017 Jan 26.
In comparison with standard two-dimensional (2D) imaging of fetal structure and biometry, we aimed to evaluate the role of three-dimensional (3D) imaging as a screening tool in the mid-trimester.
Pregnant women presenting between 18and 22 weeks for routine anatomical survey and biometric measurements were recruited. Six volumes of fetal anatomic regions were obtained and archived for later reconstruction, along with three volumes of extra-fetal structures (placenta, cervix, amniotic fluid). The 2D standard fetal images were then obtained. Offline reconstruction of 3D volumes was performed for comparative analysis (2D vs 3D). Subsequently, 3D volumes were reconstructed to mirror traditional 2D and allow biometric comparison between the two techniques. Data of 98 patients were analyzed.
Complete visualization of vital anatomic structures was seen ⩾85% of the time with 3D ultrasound. The 3D imaging improved the assessment of the four heart chambers (P=0.003), thoracic spine (P=0.008) and lumbar spine (P=0.012) views. The 2D imaging was superior for the fetal head, placenta and upper limbs. Conditional probabilities were used to assess the clinical value of 3D when standard 2D views were incomplete (mean 0.8830; 95% confidence interval 0.8059 to 0.9320). Overall diagnostic accuracy of 3D ultrasound is not superior for all fetal anatomic structures. Fetal biometric measurements assessed by both techniques demonstrated substantial to excellent agreement.
The use of 3D imaging as a primary screening tool is limited and may be best utilized as a second-stage test. Overall, there is good correlation between fetal biometry assessed by either 2D or 3D technology.
与胎儿结构和生物测量的标准二维（2D）成像相比，我们旨在评估三维（3D）成像在孕中期作为一种筛查工具的作用。
招募在18至22周前来进行常规解剖学检查和生物测量的孕妇。获取并存档六组胎儿解剖区域的容积数据以供后续重建，同时获取三组胎儿外结构（胎盘、宫颈、羊水）的容积数据。然后获取2D标准胎儿图像。对3D容积数据进行离线重建以进行对比分析（2D与3D）。随后，重建3D容积数据以模拟传统2D图像，并对两种技术进行生物测量比较。分析了98例患者的数据。
3D超声在⩾85%的时间内可实现重要解剖结构的完整可视化。3D成像改善了对四腔心（P = 0.003）、胸椎（P = 0.008）和腰椎（P = 0.012）视图的评估。2D成像在评估胎儿头部、胎盘和上肢方面更具优势。当标准2D视图不完整时，使用条件概率评估3D的临床价值（均值0.8830；95%置信区间0.8059至0.9320）。3D超声对所有胎儿解剖结构的总体诊断准确性并不更高。两种技术评估的胎儿生物测量结果显示出高度至极佳的一致性。
将3D成像用作主要筛查工具的作用有限，可能最好用作第二阶段检查。总体而言，2D或3D技术评估的胎儿生物测量之间具有良好的相关性。
