Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
BMC Med Imaging. 2022 Sep 2;22(1):154. doi: 10.1186/s12880-022-00888-1.
The aim of this study was to evaluate the accuracy and reliability of a semiautomated volumetric approach (5D CNS+™) when examining fetuses with an apparent abnormal anatomy of the central nervous system (CNS).
Stored 3D volumes extracted from a cohort of > 1.400 consecutive 2nd and 3rd trimester pregnancies (range 15-36 gestational weeks) were analyzed using the semiautomatic software tool 5D CNS+™, enabling detailed reconstruction of nine diagnostic planes of the fetal brain. All 3D data sets were examined and judged for plane accuracy, the need for manual adjustment, and fetal CNS anomalies affecting successful plane reconstruction.
Based on our data of 91 fetuses with structural cerebral anomalies, we were able to reveal details of a wide range of CNS anomalies with application of the 5D CNS+™ technique. The corresponding anatomical features and consecutive changes of neighboring structures could be clearly demonstrated. Thus, a profound assessment of the entire altered CNS anatomy could be achieved in nearly all cases. The comparison with matched controls showed a significant difference in volume acquisition (p < 0.001) and in need for manual adjustment (p < 0.001) but not in the drop-out rates (p = 0.677) of both groups.
5D CNS+™ is applicable in the majority of cases with brain lesions and constitutes a reliable tool even if the integrity of the fetal CNS is compromised by structural anomalies. Using volume data that were acquired in identical cutting sections needed for conventional biometry allows for detailed anatomic surveys grossly independent of the examiner's experience.
本研究旨在评估一种半自动容积分析方法（5D CNS+™）在检查中枢神经系统（CNS）解剖结构异常的胎儿时的准确性和可靠性。
从超过 1400 例连续的 2 至 3 期妊娠（15-36 孕周）的存储三维体积中提取数据，使用半自动软件工具 5D CNS+™ 对其进行分析，从而实现胎儿大脑的九个诊断平面的详细重建。对所有的三维数据集进行检查，并评估平面准确性、手动调整的必要性以及影响成功平面重建的胎儿 CNS 异常。
基于我们 91 例有结构脑异常的胎儿数据，我们能够应用 5D CNS+™ 技术揭示广泛的 CNS 异常的细节。可以清楚地显示相应的解剖特征和相邻结构的连续变化。因此，几乎所有病例都能对整个改变的 CNS 解剖结构进行深入评估。与匹配的对照组相比，两组在体积采集（p<0.001）和手动调整的需求（p<0.001）方面存在显著差异，但在两组的脱落率（p=0.677）方面无差异。
5D CNS+™ 适用于大多数有脑病变的病例，即使胎儿 CNS 的完整性受到结构异常的影响，它也是一种可靠的工具。使用在获取传统生物计量所需的相同切割平面获取的容积数据，可以大大减少对检查者经验的依赖，实现详细的解剖学检查。
