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不同经验操作者经阴道超声测量子宫颈夹角与子宫颈长度的可靠性比较。

Comparison of reliability between uterocervical angle and cervical length measurements by various experienced operators using transvaginal ultrasound.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.

Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.

出版信息

J Matern Fetal Neonatal Med. 2020 Apr;33(8):1419-1426. doi: 10.1080/14767058.2018.1519542. Epub 2018 Sep 25.

Abstract

To compare the reliability between uterocervical angle (UCA) and cervical length (CL) measurements by various experienced operators. Transvaginal ultrasonographies (TVS) were performed in 102 pregnant women between 16°-24° gestational weeks by different levels of experienced operators. For both CL and UCA measurements, intraobserver variability was assessed for each operator by examining the range between maximum and minimum measurements in each participant, compared to the mean of all three measurements. Interobserver variabilities were explored using Bland-Altman analysis. Intraclass correlation coefficients were used for both intraobserver and interobserver reliability. For intraobserver variability of the UCA, the ranges between maximum and minimum UCA measurements in operator 1 and 3 were 1.5º-34º and 2º-36º ( = 51), and in operators 2 and 3 were 0º-61º and 1º-25º ( = 51). Intraclass correlation coefficients (ICC) for intraobserver reliability were 0.90 for operator 1, 0.67 for operator 2 and 0.93 for operator 3. For interobserver variability of the UCA, the limits of agreement for mean UCA were -37.53º-38.41º and -36.27º-26.17º, and for maximum UCA were -39.47º-41.38º and -44.24º-22.9º in comparisons between operators 1 and 3, and operator 2 and 3, respectively. Intraclass correlation coefficients for mean UCA were 0.73 and 0.74, and for maximum UCA were 0.71 and 0.67 in comparisons between operators 1 and 3, and operator 2 and 3, respectively. The UCA measurements had a higher intra- and interobserver reliabilities than the CL measurements.

摘要

比较不同经验水平的操作者测量子宫颈口(UCA)和子宫颈长度(CL)的可靠性。102 名孕妇在 16-24 孕周时由不同经验水平的操作者行经阴道超声检查(TVS)。对于 CL 和 UCA 的测量,每位操作者通过检查每位参与者的最大和最小测量值之间的范围,与所有三次测量的平均值进行比较,评估了观察者内的变异性。通过 Bland-Altman 分析探索了观察者间的变异性。使用组内相关系数评估观察者内和观察者间的可靠性。对于 UCA 的观察者内变异性,操作者 1 和 3 的最大和最小 UCA 测量值之间的范围分别为 1.5-34 和 2-36(=51),操作者 2 和 3 的范围分别为 0-61 和 1-25(=51)。观察者内可靠性的组内相关系数(ICC)分别为 0.90(操作者 1)、0.67(操作者 2)和 0.93(操作者 3)。对于 UCA 的观察者间变异性,平均 UCA 的一致性界限分别为-37.53-38.41 和-36.27-26.17,最大 UCA 的一致性界限分别为-39.47-41.38 和-44.24-22.9,分别为操作者 1 和 3 以及操作者 2 和 3 之间的比较。平均 UCA 的组内相关系数分别为 0.73 和 0.74,最大 UCA 的组内相关系数分别为 0.71 和 0.67,分别为操作者 1 和 3 以及操作者 2 和 3 之间的比较。与 CL 测量相比,UCA 测量具有更高的观察者内和观察者间可靠性。

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