Fetal Medicine Unit, University College London Hospitals NHS Foundation Trust, London, England.
Inserm, IADI, Université de Lorraine, Nancy, France.
J Ultrasound Med. 2022 Nov;41(11):2819-2825. doi: 10.1002/jum.15969. Epub 2022 Mar 18.
To assess the intra- and interobserver reproducibility of fetal biometry measurements obtained by trainee (junior) and experienced sonographers (senior) in the contest of two training programs in obstetric ultrasound.
This was a prospective study on 192 women recruited ensuring an even distribution throughout gestation (18-41 weeks), at University College London Hospital (UCLH), England (87 cases), and at Maternité Regionale Universitaire de Nancy (MRUN), France (105 cases). The training took place in two training centers with experience in ultrasound training and subspecialist training in fetal medicine. Measurements for head circumference (HC), abdominal circumference (AC), and femur length (FL) were obtained twice by junior and senior sonographers, blind to their own and each other's measurements. Differences between and within sonographers were expressed in millimeters and as a percentage of fetal dimensions. Reproducibility was assessed using Bland-Altman plots.
Reproducibility was overall high with 95% confidence intervals (CI) within <6% for intraobserver and <8% for interobserver reproducibility. Intraobserver reproducibility was lower within junior than within senior sonographers' measurements for HC (95% CI: <4% versus <3%) and FL (95% CI: <6% and < 5%). Intraobserver reproducibility was similar between the two centers/training programs (AC 95% CI: <6%). Cumulative interobserver reproducibility in both centers was similar to the reproducibility within a single site (95% CI: <5%, <8%, and <7% for HC, AC, and FL, respectively).
Reproducibility of fetal biometry measurement was high in centers with structured training programs regardless of sonographers' experience. Reproducibility was higher in sonographers who completed the training.
评估在两个产科超声培训项目中，初级（初级）和经验丰富的超声医师（高级）获得的胎儿生物测量测量的观察者内和观察者间可重复性。
这是一项前瞻性研究，共纳入 192 名女性，在英国伦敦大学学院医院（UCLH，87 例）和法国南锡大学医院（MRUN，105 例）进行，妊娠期间（18-41 周）均匀分布。培训在两个具有超声培训经验和胎儿医学专业培训经验的培训中心进行。由初级和高级超声医师两次测量头围（HC）、腹围（AC）和股骨长（FL），彼此之间以及彼此之间的测量结果均为盲法。超声医师之间和内部的差异以毫米和胎儿尺寸的百分比表示。使用 Bland-Altman 图评估可重复性。
总体而言，可重复性很高，观察者内的 95%置信区间（CI）为<6%，观察者间的为<8%。HC（95%CI：<4%对<3%）和 FL（95%CI：<6%和<5%）的观察者内可重复性在初级医师的测量中低于高级医师。两个中心/培训计划的观察者内可重复性相似（AC 95%CI：<6%）。两个中心的累积观察者间可重复性与单个地点的可重复性相似（HC、AC 和 FL 的 95%CI 分别为<5%、<8%和<7%）。
无论超声医师的经验如何，具有结构化培训计划的中心的胎儿生物测量测量的可重复性都很高。完成培训的超声医师的可重复性更高。
