Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium.
Department of Radiology, University Hospital Brugmann, Brussels, Belgium.
Ultrasound Obstet Gynecol. 2018 Aug;52(2):250-257. doi: 10.1002/uog.17523. Epub 2018 Jul 11.
To evaluate the performance of a simple semi-automated method for estimation of fetal weight (EFW) using magnetic resonance imaging (MRI) as compared with two-dimensional (2D) ultrasound (US) for the prediction of large-for-dates neonates.
Data of two groups of women with singleton pregnancy between March 2011 and May 2016 were retrieved from our database and evaluated retrospectively: the first group included women who underwent US-EFW and MRI-EFW within 48 h before delivery and the second group included women who had these evaluations between 35 + 0 weeks and 37 + 6 weeks of gestation, more than 48 h before delivery. US-EFW was based on Hadlock et al. and MRI-EFW on the formula described by Baker et al. For MRI-EFW, planimetric measurement of the fetal body volume (FBV) was performed using a semi-automated method and the time required for measurement was noted. Outcome measure was the performance of MRI-EFW vs US-EFW in the prediction of large-for-dates neonates, both ≤ 48 h and > 48 h before delivery. Receiver-operating characteristics (ROC) curves for each method were compared using the DeLong method.
Of the 270 women included in the first group, 48 (17.8%) newborns had birth weight ≥ 90 centile and 30 (11.1%) ≥ 95 centile. The second group included 83 women, and nine (10.8%) newborns had birth weight ≥ 95 centile. Median time needed for FBV planimetric measurements in all 353 fetuses was 3.5 (range, 1.5-5.5) min. The area under the ROC curve (AUC) for prediction of large-for-dates neonates by prenatal MRI performed within 48 h before delivery was significantly higher than that by US (for birth weight ≥ 90 centile, difference between AUCs = 0.085, standard error (SE) = 0.020, P < 0.001; for birth weight ≥ 95 centile, difference between AUCs = 0.036, SE = 0.014, P = 0.01). Similarly, MRI-EFW was better than US-EFW in predicting birth weight ≥ 95 centile when both examinations were performed > 48 h prior to delivery (difference between AUCs = 0.077, SE = 0.039, P = 0.045).
MRI planimetry using our purpose-designed semi-automated method is not time-consuming. The predictive performance of MRI-EFW performed immediately prior to or remote from delivery is significantly better than that of US-EFW for the prediction of large-for-dates neonates. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
评估一种使用磁共振成像（MRI）估算胎儿体重（EFW）的简单半自动方法的性能，与二维超声（US）相比，用于预测大于胎龄儿。
我们从数据库中检索了 2011 年 3 月至 2016 年 5 月期间两组单胎妊娠妇女的数据，并进行回顾性分析：第一组包括在分娩前 48 小时内接受 US-EFW 和 MRI-EFW 的妇女，第二组包括在 35+0 周至 37+6 周妊娠期间进行这些评估的妇女，在分娩前 48 小时以上。US-EFW 基于 Hadlock 等人的公式，MRI-EFW 基于 Baker 等人的公式。对于 MRI-EFW，使用半自动方法对胎儿体体积（FBV）进行平面测量，并记录测量所需的时间。结局测量是 MRI-EFW 与 US-EFW 在预测大于胎龄儿中的表现，均≤48 小时和>48 小时前分娩。使用 DeLong 方法比较每种方法的受试者工作特征（ROC）曲线。
在第一组 270 名妇女中，48 名（17.8%）新生儿出生体重≥第 90 百分位，30 名（11.1%）≥第 95 百分位。第二组包括 83 名妇女，9 名（10.8%）新生儿出生体重≥第 95 百分位。所有 353 例胎儿的 FBV 平面测量中位数时间为 3.5（范围，1.5-5.5）分钟。在分娩前 48 小时内进行的产前 MRI 预测大于胎龄儿的 ROC 曲线下面积（AUC）明显高于 US（对于出生体重≥第 90 百分位，AUC 之间的差异=0.085，标准误差（SE）=0.020，P<0.001；对于出生体重≥第 95 百分位，AUC 之间的差异=0.036，SE=0.014，P=0.01）。同样，当两次检查均在分娩前>48 小时进行时，MRI-EFW 预测出生体重≥第 95 百分位的表现优于 US-EFW（AUC 之间的差异=0.077，SE=0.039，P=0.045）。
使用我们专门设计的半自动方法进行 MRI 平面测量并不耗时。MRI-EFW 在分娩前即刻或远离分娩时的预测性能明显优于 US-EFW，用于预测大于胎龄儿。版权所有©2017 ISUOG。由 John Wiley & Sons Ltd 出版。
