Paladini D, Parodi S, Xie H, Viñals F, Haratz K, Birnbaum R, Azumendi G, Pomar L, Montaguti E, Acharya P, Volpe P, Pérez-Cruz M, Karl K, Chaoui R, Pooh R
Fetal Medicine & Surgery Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Unit of Epidemiology and Biostatistics, Scientific Directorate, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Ultrasound Obstet Gynecol. 2025 Jun;65(6):703-711. doi: 10.1002/uog.29227. Epub 2025 May 5.
To produce reference ranges and Z-scores for corpus callosal (CC) length in the fetus, based on transvaginal three-dimensional (3D) ultrasound imaging.
This was a cross-sectional multicenter retrospective study based on 3D volume dataset acquisitions of the fetal CC between the 15 and 37 weeks of gestation. Only volume datasets acquired transvaginally through the anterior fontanelle were selected. After plane alignment on multiplanar imaging, the length of the CC was measured edge-to-edge on magnified images. Intra- and interobserver variability were assessed and the related intraclass correlation coefficients (ICC) calculated. Biometric charts to assess the reference values for fetal CC were obtained using the method proposed by Altman in 1993.
The 13 participating centers provided valid data for 2131 patients. Excellent agreement was observed for both intra- and interobserver analysis, with an ICC range of 0.98-1.00. A quadratic model was used for construction of the reference charts, modified with the insertion of cubic spline coefficients with a single knot at 18 gestational weeks, to recover an apparent lack of fit at lower gestational ages. Centile reference values and the corresponding Z-scores were produced for CC length between 15 and 37 gestational weeks.
This multicenter study presents growth charts for the fetal CC, addressing the critical methodological weaknesses of several previous studies. An even distribution of cases across all gestational weeks, robust statistical methodology and a standardized, high-resolution transvaginal neurosonographic technique represent key factors supporting the reliability of the biometric curves presented here. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
基于经阴道三维超声成像,得出胎儿胼胝体(CC)长度的参考范围和Z评分。
这是一项横断面多中心回顾性研究,基于妊娠15至37周期间胎儿CC的三维容积数据集采集。仅选择经前囟门经阴道采集的容积数据集。在多平面成像上进行平面校准后,在放大图像上从边缘到边缘测量CC的长度。评估观察者内和观察者间的变异性,并计算相关的组内相关系数(ICC)。使用1993年阿尔特曼提出的方法获得评估胎儿CC参考值的生物测量图表。
13个参与中心为2131例患者提供了有效数据。观察者内和观察者间分析均观察到极佳的一致性,ICC范围为0.98至1.00。使用二次模型构建参考图表,并通过在妊娠18周插入单个节点的三次样条系数进行修改,以弥补较低孕周时明显的拟合不足。得出了妊娠15至37周CC长度的百分位数参考值和相应的Z评分。
这项多中心研究展示了胎儿CC的生长图表,解决了此前多项研究中关键的方法学缺陷。所有孕周病例的均匀分布、稳健的统计方法以及标准化的高分辨率经阴道神经超声技术,是支持此处生物测量曲线可靠性的关键因素。© 2025作者。《超声妇产科》由约翰·威利父子有限公司代表国际妇产科超声学会出版。