Lee W, Comstock C H, Kirk J S, Smith R S, Monck J W, Deenadayalu R, Bendick P J
Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
J Ultrasound Med. 1997 Dec;16(12):799-805. doi: 10.7863/jum.1997.16.12.799.
Our validation study examined a three-dimensional ultrasonographic phantom that contained irregularly shaped volume targets ranging from 0.5 to 76.1 milliliters. Four different examiners made blinded measurements from volume datasets that were acquired by 4 and 7 MHz transducers. Birthweight predictions using abdominal and thigh volumes from 18 term fetuses also were compared with two-dimensional ultrasonographic methods. In vitro volume measurements were accurate, precise, and repeatable despite a small systematic overestimation with increasing object size. Mean systematic error and precision for birthweight predictions by three-dimensional ultrasonography (-0.03% +/- 6.1%) were not significantly different from those by two-dimensional ultrasonography (-0.60% +/- 8.8%). Conventional prediction methods yielded three birthweights with greater than 15% error. By comparison, except for one infant whose birthweight indicated an 11% error, all predictions based on fetal volume parameters were within 10% of true values. Accurate birthweight predictions by fetal volume parameters appear to be technically feasible at term gestation although their practical clinical application requires further investigation. Birthweight predictions in this manner may allow remote consultants to evaluate the fetus over wide-area computer networks despite the physical absence of the patient.
我们的验证研究检测了一个三维超声体模，其包含体积从0.5至76.1毫升不等的不规则形状的容积目标。四名不同的检查者对由4兆赫和7兆赫换能器采集的容积数据集进行了盲法测量。还将使用18例足月胎儿的腹部和大腿容积进行的出生体重预测与二维超声检查方法进行了比较。尽管随着物体尺寸增加存在小的系统性高估，但体外容积测量准确、精确且可重复。三维超声检查预测出生体重的平均系统误差和精密度（-0.03%±6.1%）与二维超声检查（-0.60%±8.8%）相比无显著差异。传统预测方法得出的三个出生体重误差大于15%。相比之下，除了一名出生体重显示有11%误差的婴儿外，所有基于胎儿容积参数的预测均在真实值的10%以内。尽管胎儿容积参数对出生体重的准确预测在足月妊娠时似乎在技术上可行，但其实际临床应用仍需进一步研究。尽管患者不在场，但以这种方式进行出生体重预测可能使远程会诊医生能够通过广域计算机网络对胎儿进行评估。
