Morales-Tisnés Tatiana, Sultan Laith R, Rouet Laurence, Jago James, Morgan Trudy A, Lerebo Wondwossen, Elsingergy Mohamed M, Srinivasan Arun, Sridharan Anush, Otero Hansel J, Darge Kassa, Back Susan J
Children's Hospital of Philadelphia, 734 Schuylkill Ave, 19146, Philadelphia, Pennsylvania, USA.
Philips (France), Suresnes, France.
Pediatr Radiol. 2025 Feb;55(2):297-304. doi: 10.1007/s00247-024-06132-y. Epub 2024 Dec 18.
We determined the reliability of a three-dimensional (3D) ultrasound (US) segmentation software for evaluating volumetric hydronephrosis index (HI) and renal parenchymal and pelvicalyceal volume in children with urinary tract dilation (UTD).
From 1/2019 to 9/2023, children clinically scheduled for a renal imaging exam to assess UTD at a single center were prospectively enrolled. They underwent a dedicated two-dimensional (2D) and 3D US renal exam. A UTD score was assigned per kidney from the 2D images based on the 2014 consensus classification by an experienced pediatric radiologist. From the 3D dataset, the renal parenchyma and collecting system were independently segmented by three trained raters using a semi-automated software. From this segmentation, the kidney parenchymal and pelvicalyceal volume, dimensions, and volumetric HI values were analyzed using the intraclass correlation coefficient to grade inter-rater reliability.
Forty-eight studies from 47 patients were included (65% male; median age 24 months; IQR 61 months). From these, 46 right and 40 left kidneys were chosen based on image quality. Twenty-nine (33.7%) kidneys had no UTD, 10 (11.6%) had UTD P1, 23 (26.7%) had UTD P2, and 24 (27.9%) had UTD P3. Inter-rater reliability was almost perfect across all parameters, with estimates ranging from 0.85 to 0.95. In sub-analysis of kidneys with UTD P2 and UTD P3, volumetric HI had the lowest inter-rater agreement (0.75 and 0.66, respectively).
Semi-automated 3D US segmentation for kidneys with UTD can reliably assess renal dimensions, parenchymal and collecting system volumes, and volumetric HI among raters.
我们确定了一种三维（3D）超声（US）分割软件在评估尿路扩张（UTD）儿童的肾盂积水体积指数（HI）以及肾实质和肾盂肾盏体积方面的可靠性。
从2019年1月至2023年9月，前瞻性纳入了在单一中心临床安排进行肾脏成像检查以评估UTD的儿童。他们接受了专门的二维（2D）和3D肾脏超声检查。由经验丰富的儿科放射科医生根据2014年共识分类从2D图像为每个肾脏分配UTD评分。从3D数据集中，三名经过培训的评估者使用半自动软件独立分割肾实质和集合系统。通过该分割，使用组内相关系数分析肾实质和肾盂肾盏体积、尺寸以及体积HI值，以评估评估者间的可靠性。
纳入了47例患者的48项研究（65%为男性；中位年龄24个月；四分位间距61个月）。从中，根据图像质量选择了46个右肾和40个左肾。29个（33.7%）肾脏无UTD，10个（11.6%）有UTD P1，23个（26.7%）有UTD P2，24个（27.9%）有UTD P3。所有参数的评估者间可靠性几乎完美，估计值范围为0.85至0.95。在UTD P2和UTD P3肾脏的亚分析中，体积HI的评估者间一致性最低（分别为0.75和0.66）。
对于UTD肾脏，半自动3D超声分割能够在评估者之间可靠地评估肾脏尺寸、实质和集合系统体积以及体积HI。
