Kim Yu Jin, Choi Young Hun, Cho Hyun Hae, Lee So Mi, Park Ji Eun, Cheon Jung-Eun, Kim Woo Sun, Kim In-One
Department of Radiology, Seoul National University Hospital, Seoul, Korea.
Department of Radiology, Chungbuk National University Hospital, Cheongju, Korea.
Ultrasonography. 2018 Jan;37(1):63-70. doi: 10.14366/usg.17009. Epub 2017 May 28.
The aim of this study was to evaluate impact of 3-dimensional cranial ultrasonography (3DUS) on reinterpretation of cranial ultrasonography images in neonates in comparison with 2-dimensional cranial ultrasonography (2DUS).
We retrospectively enrolled 50 young infants who simultaneously underwent both 2DUS and 3DUS scanning from February to March 2015. Two pediatric radiologists independently reviewed both scans for overall image quality on a 5-point scale. Five features were evaluated in both scans: the presence of germinal matrix hemorrhage (GMH), intraventricular hemorrhage (IVH), ventriculomegaly (VM), abnormality of periventricular echogenicity (PVE), and focal parenchymal lesions (FL). The concordance rate between the two scanning modes was calculated. The confidence level for each finding on a 3-point scale and the scanning time were compared between the two scanning modes. Interobserver agreement was evaluated using kappa statistics.
Both scans demonstrated similar overall image quality in terms of reinterpretation (mean scores for 2DUS and 3DUS, 4.0±0.5 and 4.0±0.7 in reviewer 1, 3.9±0.6 and 4.0±0.8 in reviewer 2, respectively). GMH, IVH, VM, and FL showed perfect concordance, while PVE showed a concordance rate of 91.4% between the two modes by both reviewers. 3DUS was associated with a higher diagnostic confidence in the evaluation of GMH, IVH, and FL than 2DUS (P<0.05) for both reviewers. For PVE, 3DUS received a significantly higher confidence score than 2DUS from one of the reviewers. The mean scanning time for 2DUS and 3DUS was 92.75 seconds and 36 seconds, respectively. Interobserver agreement for qualitative scoring was almost perfect.
In reinterpretation, 3DUS showed very high concordance with 2DUS and a similar image quality. 3DUS also increased diagnostic confidence for several image findings and significantly decreased scan time.
本研究旨在评估三维颅脑超声检查（3DUS）与二维颅脑超声检查（2DUS）相比，对新生儿颅脑超声图像重新解读的影响。
我们回顾性纳入了2015年2月至3月同时接受2DUS和3DUS扫描的50例幼儿。两名儿科放射科医生独立以5分制评估两种扫描的整体图像质量。在两种扫描中评估五个特征：生发基质出血（GMH）、脑室内出血（IVH）、脑室扩大（VM）、脑室周围回声异常（PVE）和局灶性实质病变（FL）。计算两种扫描模式之间的一致性率。比较两种扫描模式下每项发现的3分制置信水平和扫描时间。使用kappa统计评估观察者间的一致性。
在重新解读方面，两种扫描显示出相似的整体图像质量（审阅者1中2DUS和3DUS的平均得分分别为4.0±0.5和4.0±0.7，审阅者2中分别为3.9±0.6和4.0±0.8）。GMH、IVH、VM和FL显示出完美的一致性，而两位审阅者均显示两种模式下PVE的一致性率为91.4%。对于两位审阅者，3DUS在评估GMH、IVH和FL方面比2DUS具有更高的诊断置信度（P<0.05）。对于PVE，其中一位审阅者给予3DUS的置信度评分明显高于2DUS。2DUS和3DUS的平均扫描时间分别为92.75秒和36秒。定性评分的观察者间一致性几乎完美。
在重新解读中，3DUS与2DUS显示出非常高的一致性和相似的图像质量。3DUS还提高了对几种图像发现的诊断置信度，并显著缩短了扫描时间。
