摘要
目的探讨胎儿心脏超声智能导航技术(FINE)在诊断法洛四联症(TOF)中的应用价值。资料与方法纳入经胎儿心脏超声(FE)初步拟诊为TOF的孕妇66例,以产后随访、手术或尸检为诊断"金标准"。使用三维容积探头采集胎儿心脏图像数据,由3位不同诊断经验的超声医师作为观察者(A诊断经验丰富,B、C经验不足;C1和C2为C在2次不同时间的评分),分别应用FINE对图像进行后处理,读取诊断并进行评分,比较FE与FINE之间、不同医师之间以及同一医师内部诊断评分的一致性。结果17例TOF入选。医师A和B应用FINE所获得的评分与FE、"金标准"有较高的一致性(P均>0.05),而医师C1获得评分差异有统计学意义(P=0.004)。医师A和B所获得的评分有高度一致性(A评分为5分和3分者分别为15例、2例,B评分为别为8例和9例,P=0.577),医师B和C1差异无统计学意义(C1评分为5分和3分者分别为4例、13例,P=1.000),而医师A和C1所获得的评分差异有统计学意义(P=0.029)。C1和C2所获得的评分一致性较好(P=0.317)。医师A所需时间明显少于B(P=0.004)和C1(P<0.001)。结论应用FINE可诊断胎儿TOF,观察者内部和观察者之间具有良好的重复性。
Purpose To investigate the diagnostic application of fetal intelligent navigation echocardiography(FINE) in the fetal tetralogy of Fallot(TOF). Materials and Methods A total of 66 pregnant women with fetuses at 22 to 32 weeks of gestational age were enrolled and were diagnosed as TOF via fetal echocardiography(FE), and follow-up, operation or autopsy were regarded as "gold standard" diagnosis of TOF in this study. The volume data of fetal heart were collected via spatiotemporal image correlation(STIC). The volume data of fetal heart were analyzed via FINE by three observers with different seniority of FE, including A observer with rich experience, B and C observers with inexperience, and C1 and C2 were graded at different two times by C observer, respectively. And all of the images were diagnosed and scored. The studies on the different observers and imaging methods including FE and FINE were statistically compared to analyze the consistency in diagnostic scores. Results Seventeen out of 66 TOF cases were finally enrolled. The scores obtained by A observer(with rich experience) and B observer(with less experience) via FINE were consistent with FE(all P>0.05). There was a significant difference in the scores between physician C1(with less experience) using FINE and FE(P=0.004). Similar results were obtained when compared with gold standards. The score of B observer was highly consistent with A observer(P=0.577), and there was no significant difference in score between B observer and C1 observer(P=1.000). However, there was a significant difference in score between A observer and C1 observer(P=0.029). There was no significant difference in score between C1 and C2 observers(P=0.317). In the comparison of the time required for diagnosis among three observers, A observer was significantly shorter than B(P=0.004) and C1(P<0.001). Conclusion FINE can be available to diagnose fetal TOF with good inter-observer and intra-observer repeatability.
作者
汪贤臣
赵博文
李世岩
袁华
彭晓慧
潘美
陈冉
WANG Xianchen;ZHAO Bowen;LI Shiyan;YUAN Hua;PENG Xiaohui;PAN Mei;CHEN Ran(Department of Diagnostic Ultrasound&Echocardiography,Sir Run Run Shaw Hospital,Zhejiang University College of Medicine,Technical Guidance Center for Fetal Echocardiography of Zhejiang Province,Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University,Hangzhou 310016,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2021年第6期603-608,613,共7页
Chinese Journal of Medical Imaging
基金
浙江省基础公益研究计划项目(LGF18H180015)。
