Braithwaite J M, Kadir R A, Pepera T A, Morris R W, Thompson P J, Economides D L
University Department of Obstetrics and Gynaecology, Royal Free Hospital, London, UK.
Ultrasound Obstet Gynecol. 1996 Sep;8(3):192-5. doi: 10.1046/j.1469-0705.1996.08030192.x.
The aim of this study was to assess a training regimen for nuchal translucency measurement by transabdominal (TAS) and transvaginal sonography (TVS). After initial instruction regarding the criteria for correct nuchal translucency measurement, trainees (A and B) and an experienced examiner (C) performed nuchal translucency measurements on fetuses of 10-13 weeks' gestation, and the trainees' ability to obtain a measurement, repeatability and levels of agreement were assessed. In addition, a further experienced examiner (D) performed nuchal translucency measurements to validate the training regimen. Examiner C obtained nuchal translucency measurements in 94% by TAS, 93% by TVS and 100% by a combination of both scan modes. The repeatability coefficient was 0.40 mm and 0.24 mm for TAS and TVS, respectively. Trainees A and B were considered trained after 80 and 100 scans with TAS and TVS, respectively. They were considered trained when they could consistently obtain measurements that were of comparable repeatability and comparable levels of agreement with those of examiner C. The trainees' difficulties with TAS were in achieving satisfactory repeatability and levels of agreement, but with TVS it was ability in obtaining a measurement. We propose the training methods, standards and criteria used in this study as the basis for training sonographers in nuchal translucency measurements.
本研究的目的是评估经腹超声（TAS）和经阴道超声（TVS）测量颈项透明层的训练方案。在接受关于正确测量颈项透明层标准的初步指导后，学员（A和B）以及一位经验丰富的检查者（C）对妊娠10 - 13周的胎儿进行颈项透明层测量，并评估学员获取测量值的能力、重复性和一致性水平。此外，另一位经验丰富的检查者（D）进行颈项透明层测量以验证该训练方案。检查者C通过TAS获得颈项透明层测量值的比例为94%，通过TVS为93%，通过两种扫描模式联合使用为百分之百。TAS和TVS的重复性系数分别为0.40毫米和0.24毫米。学员A和B分别在进行80次TAS扫描和100次TVS扫描后被认为训练合格。当他们能够持续获得与检查者C具有可比重复性和可比一致性水平的测量值时，即被认为训练合格。学员在TAS方面的困难在于实现令人满意的重复性和一致性水平，但在TVS方面的困难在于获取测量值的能力。我们建议将本研究中使用的训练方法、标准和标准作为超声检查医师进行颈项透明层测量培训的基础。
