Department of Obstetrics and Gynecology, Miyake Clinic, Okayama, Japan.
Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan.
J Matern Fetal Neonatal Med. 2022 Dec;35(23):4573-4579. doi: 10.1080/14767058.2020.1856808. Epub 2020 Dec 6.
To evaluate the 24-segment sphericity index (SI) of the fetal heart using HQ regarding the change with advancing gestation and reproducibility.
Eighty-one pregnant women at 18-21 + 6 and 28-31 + 6 weeks were studied using HQ to calculate 24-segment SI of left and right ventricles. Intra- and inter-class correlation coefficients and intra- and inter-observer agreements of measurements for SI were assessed in each segment.
With respect to intra-observer reproducibility, all SI values showed correlations between 0.596 and 0.774 for the left ventricle, and between 0.491 and 0.764 for the right ventricle, with good intra-observer agreements except for right ventricular segment 11-15. With respect to inter-observer reproducibility, all SI values showed correlations between 0.473 and 0.755 for the left ventricle, and between 0.48 and 0.767 for the right ventricular segment 1-18. However, right ventricular segment 19-24 showed no correlations. Good inter-observer agreements were noted in the right ventricle, whereas poor inter-observer agreements were evident in the left ventricle.There were significant differences in the mean SI values in the apical segment of the left ventricle between 18-21 + 6 and 28-31 + 6 weeks ( < .05), whereas there were no significant differences in the mean SI values in the right ventricle between both gestational ages.
These results show that measurements of 24-segment SI of fetal heart had relatively low reliability of measurements performed by experienced sonographers. This may suggest that more training on proper placement of the 3 end-systolic and end-diastolic reference points during the initial analysis may be relevant.
使用 HQ 评估胎儿心脏 24 节段球形体指数（SI）在妊娠进展过程中的变化及其可重复性。
对 81 名 18-21+6 周和 28-31+6 周的孕妇进行 HQ 检查，计算左、右心室 24 节段 SI。评估各节段 SI 测量的内-观察者和间-观察者相关性和一致性。
就内-观察者可重复性而言，左心室所有 SI 值的相关性在 0.596 至 0.774 之间，右心室所有 SI 值的相关性在 0.491 至 0.764 之间，除右心室节段 11-15 外，具有良好的内-观察者一致性。就间-观察者可重复性而言，左心室所有 SI 值的相关性在 0.473 至 0.755 之间，右心室所有 SI 值的相关性在 0.48 至 0.767 之间。然而，右心室节段 19-24 没有相关性。右心室观察者间具有良好的一致性，而左心室观察者间一致性较差。左心室心尖段的平均 SI 值在 18-21+6 周和 28-31+6 周之间存在显著差异（<0.05），而右心室的平均 SI 值在两个孕龄之间没有显著差异。
这些结果表明，经验丰富的超声医师对胎儿心脏 24 节段 SI 的测量具有相对较低的测量可靠性。这可能表明，在最初的分析中，对 3 个收缩末期和舒张末期参考点的正确放置进行更多的培训可能是相关的。
