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Khan AA, Al-Motawa A, Halabi N, Ahmed B, Rafii JA, Konje JC. An investigation of endometrial vascularity in normally menstruating women and those in other physiological states using 3D ultrasound imaging. Int J Gynaecol Obstet 2024; 165:1172-1181. [PMID: 38217113 DOI: 10.1002/ijgo.15326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 11/12/2023] [Accepted: 12/11/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES This study aimed to determine the normal vasculature indices of the endometrium and to correlate them with those in various physiological states. METHODS Women undergoing ultrasound at the Feto-Maternal Center, Qatar in 2020-2021 as part of their gynecologic evaluation were enrolled into the study. They were divided into those with normal menses and no additional pathology, those following spontaneous miscarriage, postpartum and menopausal. Three-dimensional (3D) evaluation of the endometrial vasculature was done and the parameters quantified included vascularization index (VI), flow index (FI), vascularization flow index (VFI), endometrial thickness, endometrial volume and uterine volume. JASP, an open-source statistical analysis software, was used for analysis and an independent t-test to compare the vascularity indices. A multivariate regression analysis was also done to look at the factors affecting the endometrial vascular indices within the luteal phase. RESULTS A total of 461 women were studied: 122 in the follicular phase, 199 in the luteal phase, 90 after a spontaneous miscarriage, 29 postpartum, and 16 menopausal. The vascularity indices were highest after miscarriage and lowest postnatally. There were no significant effects of age, gravida, para, or abortions on VI and VFI. However, there was a significant positive effect of age on FI (P = 0.019) There was a significant increase in endometrial volume and thickness in the luteal phase as compared to follicular phase (P < 0.01), but there was no difference in the vascularity indices. The uterine and endometrial volume in the postnatal group were nearly double that of the luteal group (P value <0.01 and 0.014, respectively). There was a significant decrease in flow index in the postnatal group compared to the luteal group (P < 0.01), suggesting low flow intensity in the postnatal group. CONCLUSIONS Endometrial vascular indices measured using 3D Doppler can be used to determine normal vascular indices and vary with physiological states such as after miscarriages, postnatally and in the menopausal states.
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Affiliation(s)
- Ammar Ahmed Khan
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
| | | | - Najeeb Halabi
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Badreldeen Ahmed
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, Qatar University, Doha, Qatar
- The Feto Maternal Medical Center, Doha, Qatar
| | - Jeremie Arash Rafii
- Department of Genetic Medicine, Obstetrics and Gynecology, Weill Cornell Medicine Qatar, Education City, Qatar Foundation, Doha, Qatar
- Department of Gynecologic Oncology, Weill Cornell Medicine Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Justin C Konje
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, Qatar University, Doha, Qatar
- The Feto Maternal Medical Center, Doha, Qatar
- Department of Obstetrics and Gynecology, The University of Leicester, Leicester, UK
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Benavente-Fernández I, Steggerda SJ, Liem KD, Lubián-López S, de Vries LS. Ultrasonographic Estimation of Ventricular Volume in Infants Born Preterm with Posthemorrhagic Ventricular Dilatation: A Nested Substudy of the Randomized Controlled Early Versus Late Ventricular Intervention Study (ELVIS) Trial. J Pediatr 2023; 261:113578. [PMID: 37353143 DOI: 10.1016/j.jpeds.2023.113578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/29/2023] [Accepted: 06/16/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To study the potential role of ventricular volume (VV) estimation in the management of posthemorrhagic ventricular dilatation related to the need for ventriculoperitoneal (VP)-shunt insertion and 2-year neurodevelopmental outcome in infants born preterm. STUDY DESIGN We included 59 patients from the Early vs Late Ventricular Intervention Study from 4 participating centers. VV was manually segmented in 209 3-dimensional ultrasound scans and estimated from 2-dimensional ultrasound linear measurements in a total of 1226 ultrasounds. We studied the association of both linear measurements and VV to the need for VP shunt and 2-year neurodevelopmental outcome in the overall cohort and in the 29 infants who needed insertion of a reservoir. We used general estimating equations to account for repeated measures per individual. RESULTS Maximum pre-reservoir VV (β coefficient = 0.185, P = .0001) and gestational age at birth (β = -0.338; P = .0001) were related to the need for VP shunt. The estimated optimal single VV measurement cut point of 17 cm3 correctly classified 79.31% with an area under the curve of 0.76 (CI 95% 0.74-0.79). Maximum VV (β = 0.027; P = .012) together with VP shunt insertion (β = 3.773; P = .007) and gestational age (β = -0.273; P = .0001) were related to cognitive outcome at 2 years. Maximum ventricular index and anterior horn width before reservoir insertion were independently associated with the need of VP shunt and the proposed threshold groups in the Early vs Late Ventricular Intervention Study trial were associated with long-term outcome. CONCLUSIONS Pre-reservoir VV measurements were associated with the need for VP-shunt insertion and 2-year cognitive outcome among infants born preterm with posthemorrhagic ventricular dilatation. TRIAL REGISTRATION ISRCTN43171322.
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Affiliation(s)
- Isabel Benavente-Fernández
- Area of Paediatrics, Department of Child and Mother Health and Radiology, Medical School, University of Cádiz, Cádiz, Spain; Division of Neonatology, Department of Paediatrics, Puerta del Mar University Hospital, Cádiz, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University, Cádiz, Spain.
| | - Sylke J Steggerda
- Division of Neonatology, Department of pediatrics, Leiden University Medical Center, Willem-Alexander Children's Hospital, Leiden, The Netherlands
| | - Kian D Liem
- Division of Neonatology, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Simón Lubián-López
- Division of Neonatology, Department of Paediatrics, Puerta del Mar University Hospital, Cádiz, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University, Cádiz, Spain
| | - Linda S de Vries
- Division of Neonatology, Department of pediatrics, Leiden University Medical Center, Willem-Alexander Children's Hospital, Leiden, The Netherlands; Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands
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Milani HJF, Barreto EQDS, Araujo Júnior E, Cavalheiro S, Barbosa MM, Peixoto AB, Moron AF. Assessment of lower limb trophism in fetuses with open spina bifida using fractional thigh volume of three-dimensional ultrasound. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:409-414. [PMID: 36223260 DOI: 10.1002/jcu.23364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/12/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To assess the trophism of the lower limbs of fetuses with open spina bifida using fractional thigh volume (TVOL) of three-dimensional (3D) ultrasound. METHODS A prospective cross-sectional study was carried out with normal fetuses and with open spina bifida (myelomeningocele and rachischisis) at 26 weeks' gestation. The TVOL (delimitation of five cross-sectional areas of the middle portion of the limb) was evaluated, as well as the subjective assessment of hypotrophy and lower limb movement. RESULTS Thirty-one fetuses with open spina bifida, 21 with myelomeningocele and 10 with rachischisis, and 51 normal fetuses were included. There were no significant differences in the TVOL between normal and spina bifida fetuses (p = 0.623), as well as between normal fetuses, with myelomeningocele and with rachischisis (p = 0.148). There was no significant difference in the TVOL of fetuses with spina bifida with or without lower limb hypotrophy (p = 0.148). Fetuses with spina bifida and with lower limb movement had higher TVOL values than fetuses without lower limb movement (p = 0.002). CONCLUSION There were no significant differences in the TVOL measurement of normal and spina bifida fetuses (rachischisis and myelomeningocele). Fetuses with spina bifida without spontaneous movement of the lower limbs had lower TVOL values.
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Affiliation(s)
- Hérbene José Figuinha Milani
- Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
- Department of Fetal Medicine, Hospital e Maternidade Santa Joana, São Paulo, SP, Brazil
| | | | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
| | - Sérgio Cavalheiro
- Department of Neurology and Neurosurgery, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
- Department of Fetal Neurosurgery, Hospital e Maternidade Santa Joana, São Paulo, SP, Brazil
| | - Maurício Mendes Barbosa
- Department of Fetal Medicine, Hospital e Maternidade Santa Joana, São Paulo, SP, Brazil
- Service of Gynecology and Obstetrics, Israeli Faculty of Health Sciences Albert Einstein, São Paulo, SP, Brazil
| | - Alberto Borges Peixoto
- Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, Brazil
- Gynecology and Obstetrics Service, Mário Palmério University Hospital, University of Uberaba (UNIUBE), Uberaba, MG, Brazil
| | - Antonio Fernandes Moron
- Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
- Department of Fetal Medicine, Hospital e Maternidade Santa Joana, São Paulo, SP, Brazil
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Xu C, Wang W, Yang B, Zhu M. Subchorionic Hematoma Volume Measured by Virtual Organ Computer-Aided Analysis in the Prediction of First-Trimester Pregnancy Outcome. Ultrasound Q 2022; 38:291-296. [PMID: 36223480 DOI: 10.1097/ruq.0000000000000627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACT This study aimed to assess the association of subchorionic hematoma (SCH) size measured by virtual organ computer-aided analysis (VOCAL) with the first-trimester pregnancy outcome. A total of 139 first-trimester pregnancies from 6 to 12 weeks of gestational age with SCH were included. The circumference, area, and volume of the SCH (Cs, As, and 3DVs) and gestational sac (Cg, Ag, and 3DVg) were automatically calculated by VOCAL. Interobserver agreement was assessed with the intraclass correlation coefficient and Bland-Altman plot. Odds ratios for the clinical and ultrasound characteristics of adverse pregnancy outcomes were estimated by univariate or multivariable logistic regression. There was high interobserver agreement in VOCAL measurements of the SCH and gestational sac (intraclass correlation coefficients, >0.900). By univariate regression analysis, women with adverse pregnancy outcomes were more likely to have vaginal bleeding, a larger As and 3DVs, and higher Cs/Cg, As/Ag, and 3DVs/3DVg ratios (all P < 0.05). In the multivariable regression analysis, a higher 3DVs/3DVg ratio of SCH (odds ratio, 1.034; 95% confidence interval [CI], 1.015-1.053; P = 0.000) and vaginal heavy bleeding had a significant positive relationship with the risk of adverse pregnancy outcomes (odds ratio, 7.846; 95% CI, 1.104-55.737; P = 0.039) remained associated with an increased risk of adverse pregnancy outcomes. With 11.87% as the cutoff, the receiver operating characteristic curve yielded a good predictive performance (area under the curve, 0.713) and high sensitivity (91.18%). The measurements of SCH by VOCAL provide high reliability for estimating the total hematoma burden in first-trimester pregnant patients. A greater volume proportion (3DVs/3DVg) of SCH worsens the pregnancy outcome, and a greater risk of adverse pregnancy outcome also associated with the severity of vaginal bleeding.
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Affiliation(s)
- Chaoli Xu
- Department of Ultrasound Diagnostics, The First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Wenrong Wang
- Ultrasound Department, Lianyungang Maternal and Child Health Hospital, Lianyungang
| | - Bin Yang
- Department of Ultrasound Diagnostics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, P.R. China
| | - Minmin Zhu
- Ultrasound Department, Lianyungang Maternal and Child Health Hospital, Lianyungang
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Xydias EM, Kalantzi S, Tsakos E, Ntanika A, Beis N, Prior M, Daponte A, Ziogas AC. Comparison of 3D ultrasound, 2D ultrasound and 3D Doppler in the diagnosis of endometrial carcinoma in patients with uterine bleeding: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2022; 277:42-52. [PMID: 35988462 DOI: 10.1016/j.ejogrb.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/21/2022] [Accepted: 08/06/2022] [Indexed: 11/04/2022]
Abstract
Endometrial cancer is a common malignancy affecting women worldwide. Usually, it clinically manifests with uterine bleeding, although identical clinical manifestations occur in benign conditions as well, with several endometrial biopsies being conducted unnecessarily. Therefore, an accurate, non-invasive diagnostic test is needed for first-line assessment, so as unnecessary biopsies are limited as much as possible. This systematic review aims to assess the diagnostic accuracy of three-dimensional ultrasound, a relatively novel method in gynecologic assessment, compared to two-dimensional ultrasound and three-dimensional Doppler in the prediction of uterine malignancy in women with abnormal uterine bleeding. The accuracy of endometrial volume, as a diagnostic parameter assessed by three-dimensional ultrasound is compared to diagnostic parameters from the other two methods, namely endometrial thickness and 3D Doppler indices (vascularization index, flow index and vascularization flow index). Articles relevant to our research question were systematically sought in the Web of Science, Scopus and MEDLINE/PubMed databases and underwent rigorous evaluation for inclusion according to the PRISMA 2020 guidelines. Eligible studies were thoroughly assessed for risk of bias and relevant data was extracted and analyzed. Studies were heterogenous and extracted data varied from study to study. Data on endometrial volume was compared to other diagnostic parameters. Forest plots with pooled percentages and hierarchical summary receiver operating characteristic curves were constructed for each comparison. Relative sensitivity and specificity ratios were calculated for each comparison to test for statistical significance. Endometrial volume and thickness comparison showed sensitivity 83% for both parameters and specificity 75% and 69% respectively, with volume being more specific than thickness (p < 0.05). Endometrial volume and Doppler indices comparison showed that sensitivity was 73%, 82%, 81% and 82%, while specificity was 72%, 76%, 75% and 76% for endometrial volume, vascularization index, flow index and vascularization-flow index respectively. All three Doppler indices were significantly more sensitive in the diagnosis of malignancy compared to endometrial volume (p < 0.05) While endometrial thickness remains a reliable predictor of uterine malignancy, endometrial volume appears promising as a method with higher specificity and more reliable measurements. Similarly, vascular indices seem as competent and even more sensitive than endometrial volume as predictors, with the added advantage of semi-automated and reproducible measurements that reflect the whole organ. More comparative studies with standardized protocols should be established, so as reliable cut-off values can be determined and thus standardize and streamline the diagnostic algorithm via the implementation of the three-dimensional modalities in the settings that they are available.
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Affiliation(s)
- Emmanouil M Xydias
- University of Thessaly, School of Health Sciences, Faculty of Medicine, Biopolis 41334, Larissa, Greece
| | - Sofia Kalantzi
- University of Thessaly, School of Health Sciences, Faculty of Medicine, Biopolis 41334, Larissa, Greece
| | - Elias Tsakos
- EmbryoClinic, Adrianoupoleos 6, 55133 Thessaloniki, Greece
| | - Anna Ntanika
- University of Ioannina, School of Health Sciences, Faculty of Medicine, Kourmanio Campus, 45100 Ioannina, Greece
| | - Nikolaos Beis
- University of Thessaly, School of Health Sciences, Faculty of Medicine, Biopolis 41334, Larissa, Greece
| | - Matthew Prior
- Consultant and Subspecialist in Reproductive Medicine, Head of Department, Newcastle Fertility Centre, International Centre for Life, Newcastle NE1 4EP, UK
| | - Alexandros Daponte
- University of Thessaly, School of Health Sciences, Faculty of Medicine, Biopolis 41334, Larissa, Greece; University of Thessaly, Department of Obstetrics and Gynecology, Larissa General University Hospital, Biopolis 41334, Larissa, Greece
| | - Apostolos C Ziogas
- University of Thessaly, School of Health Sciences, Faculty of Medicine, Biopolis 41334, Larissa, Greece.
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Becsek A, Tzanidakis N, Blanco M, Schmicke M, Bollwein H. Transrectal three-dimensional fetal volumetry in early pregnant mares: Relationships between maternal factors and equine fetal volume measurements. Theriogenology 2021; 174:20-26. [PMID: 34416560 DOI: 10.1016/j.theriogenology.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/24/2021] [Accepted: 08/05/2021] [Indexed: 12/28/2022]
Abstract
The aim of this study was to investigate the effects of maternal, hormonal, and fetal factors on early fetal volume (FV) measurements in mares obtained by three-dimensional (3D) ultrasound. Furthermore, postpartum parameters were explored in regard to their association with early FV. For this purpose, 149 German warmblood mares that were artificially inseminated and confirmed to be pregnant between days 14-16 of gestation, were examined transrectally at day 45 ± 1 of gestation with the portable 3D ultrasound device Voluson® i (GE, Zipf, Austria). FV was calculated by using the extension software Virtual Organ Computer-aided AnaLysis (VOCAL™). Two different mixed linear models were used to analyze associations between the investigated maternal and fetal factors and the FV. Explanatory variables investigated in the first model were: maternal age, parity, maternal weight, and body condition score, type of pregnancy (recipient or biological mother), barren status (lactating or non-lactating), fetal sex, progesterone (P4) and equine chorionic gonadotropin (eCG) concentrations; and in the second model outcome variables such as gestational length, birth weight, placental weight, fetal sex, and abortion were included in the analysis. The final models revealed a significant relation between FV and eCG (b = 0.011, P = 0.030), as well as with P4 (b = -0.053, P = 0.016), but interestingly P4 was negatively related to FV. Fetal sex showed the most prominent effect on FV (b = -0.256, P = 0.039), with female fetuses being smaller than male fetuses. In the second model none of the investigated parameters were related to early FV except for fetal sex (b = -0.328, P = 0.047), again with female fetuses being smaller. In summary, it was found that FV is related with eCG, P4 and fetal sex, but was no suitable predicting factor for the investigated outcome parameters. Furthermore, the findings suggest that sex specific growth differences exist already in early gestation. The detailed biological mechanism by which P4 and eCG affect fetal size has to be investigated in prospective studies.
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Affiliation(s)
- Angela Becsek
- Clinic of Reproductive Medicine, Vetsuisse Faculty, Winterthurerstrasse 260, 8057 Zürich, Switzerland.
| | - Nikolaos Tzanidakis
- Clinic of Reproductive Medicine, Vetsuisse Faculty, Winterthurerstrasse 260, 8057 Zürich, Switzerland.
| | - Miguel Blanco
- Gestüt Lewitz, PS Pferdehaltung GmbH, Lewitzhof 1, 19306 Neustadt-Glewe, Germany.
| | - Marion Schmicke
- Clinic for Cattle, University of Veterinary Medicine Hannover, 30173, Hannover, Germany.
| | - Heinrich Bollwein
- Gestüt Lewitz, PS Pferdehaltung GmbH, Lewitzhof 1, 19306 Neustadt-Glewe, Germany.
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A 10-Year Retrospective Review of Prenatal Applications, Current Challenges and Future Prospects of Three-Dimensional Sonoangiography. Diagnostics (Basel) 2021; 11:diagnostics11081511. [PMID: 34441444 PMCID: PMC8394388 DOI: 10.3390/diagnostics11081511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 12/12/2022] Open
Abstract
Realistic reconstruction of angioarchitecture within the morphological landmark with three-dimensional sonoangiography (three-dimensional power Doppler; 3D PD) may augment standard prenatal ultrasound and Doppler assessments. This study aimed to (a) present a technical overview, (b) determine additional advantages, (c) identify current challenges, and (d) predict trajectories of 3D PD for prenatal assessments. PubMed and Scopus databases for the last decade were searched. Although 307 publications addressed our objectives, their heterogeneity was too broad for statistical analyses. Important findings are therefore presented in descriptive format and supplemented with the authors’ 3D PD images. Acquisition, analysis, and display techniques need to be personalized to improve the quality of flow-volume data. While 3D PD indices of the first-trimester placenta may improve the prediction of preeclampsia, research is needed to standardize the measurement protocol. In highly experienced hands, the unique 3D PD findings improve the diagnostic accuracy of placenta accreta spectrum. A lack of quality assurance is the central challenge to incorporating 3D PD in prenatal care. Machine learning may broaden clinical translations of prenatal 3D PD. Due to its operator dependency, 3D PD has low reproducibility. Until standardization and quality assurance protocols are established, its use as a stand-alone clinical or research tool cannot be recommended.
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Seol HJ, Kim HY, Cho GJ, Oh MJ. Hourly fetal urine production rate in isolated oligohydramnios at term. PLoS One 2021; 16:e0250659. [PMID: 34019576 PMCID: PMC8139465 DOI: 10.1371/journal.pone.0250659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 04/08/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the hourly fetal urine production rate (HFUPR) via three-dimensional ultrasonography in women with isolated oligohydramnios and compare with normal pregnant women at term. MATERIALS AND METHODS This was a prospective observational cohort study of 112 women from 34 to 40 6/7 weeks' gestation. They were classified into three groups according to the amniotic fluid index (AFI) and ultrasonographic estimated fetal weight (EFW) as isolated oligohydramnios (defined as AFI below 5% and appropriate EFW corresponding to gestational age) (n = 34) and IUGR (defined as EFW below 5% corresponding to gestational age irrespective amniotic fluid) (n = 17), and normal pregnancy (n = 61). HFUPR was measured using three-dimensional virtual organ computer-aided analysis. Adverse perinatal outcomes in all participants were examined. RESULTS There was no significant difference in HFUPR between patients with isolated oligohydramnios and women with normal pregnancies (median, 40.0 mL/h [interquartile range [IQR] 31.0-66.5] vs. 48.6 [31.5-81.2], p = 0.224). HFUPR was significantly decreased in the IUGR group (13.8 mL/h [IQR 10.1-24.8]), compared to the normal pregnancy group (p<0.001) and the isolated oligohydramnios group (p<0.001). HFUPR was significantly decreased in neonates with adverse perinatal outcomes compared to the control (24.7 mL/h [IQR 13.4-47.4] vs. 43.6 [29.8-79.0], p = 0.016). CONCLUSION HFUPR was not decreased in patients with isolated oligohydramnios but was decreased in patients with IUGR when compared to normal controls at term.
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Affiliation(s)
- Hyun-Joo Seol
- Department of Obstetrics & Gynecology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Ho Yeon Kim
- Department of Obstetrics & Gynecology, College of Medicine, Korea University, Seoul, Korea
| | - Geum-Joon Cho
- Department of Obstetrics & Gynecology, College of Medicine, Korea University, Seoul, Korea
| | - Min-Jeong Oh
- Department of Obstetrics & Gynecology, College of Medicine, Korea University, Seoul, Korea
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Dückelmann AM, Wordell J, Richter R, Sehouli J. 3D ultrasound as a surgical quality control of conization in patients with severe dysplasia: a prospective study. Arch Gynecol Obstet 2020; 302:1189-1196. [PMID: 32740870 PMCID: PMC7524827 DOI: 10.1007/s00404-020-05718-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 07/27/2020] [Indexed: 11/27/2022]
Abstract
Purpose To compare the techniques for cone measurement with ultrasound to determine the size of the resected tissue and to evaluate parameters which may be relevant for stratifying women at risk who need surveillance when pregnant. Methods The present study included women with a pathological cervical biopsy. Cervical length and volume were determined by transvaginal ultrasound prior to conization. The pathologist measured the volume of the removed tissue by the fluid displacement technique and using a ruler. A repeat transvaginal ultrasound was performed during a follow-up visit. Factors affecting cone volume as well as the correlation between measurement techniques were analyzed. Results A total of 28 patients underwent cervical excision treatment. The mean cervical volumes measured sonographically before and after the operation were 17.72 ± 7.34 and 13.21 ± 5.43 cm3, respectively. The proportion of volume excised was 25.50 ± 17.43%. A significant correlation was found between the cone depth and the cone volume measured by the fluid displacement technique, and histopathologically and sonographically measured difference in cervical volume. The interobserver reliability coefficient was > 0.9. Analyzing influential parameters, only age affected the extent of cone volume and the correlation between the three measurement techniques. Conclusion Commonly applied techniques of cervical and cone measurement are equivalent and interchangeable. Our ultrasound data show variety in the volume and length of the cervix, and in the proportion of the volume excised at conization. Ultrasound measurements may help the surgeon to estimate not only the dimension of the remaining cervix but also its function.
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Affiliation(s)
- Anna M Dückelmann
- Department of Gynecology, Medical University of Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Julia Wordell
- Department of Gynecology, Ruppiner Kliniken, Fehrbelliner Str. 38, 16816, Neuruppin, Germany
| | - Rolf Richter
- Department of Gynecology, Medical University of Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology, Medical University of Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Abstract
The shape and contour of the lesion are shown to be effective features for physicians to identify breast tumor as benign or malignant. The region of the lesion is usually manually created by the physician according to their clinical experience; therefore, contouring tumors on breast magnetic resonance imaging (MRI) is difficult and time-consuming. For this purpose, an automatic contouring method for breast tumors was developed for less burden in the analysis and to decrease the observed bias to help in making decisions clinically. In this study, a multiview segmentation method for detecting and contouring breast tumors in MRI was represented. The preprocessing of the proposed method reduces any amount of noises but preserves the shape and contrast of the breast tumor. The two-dimensional (2D) level-set segmentation method extracts contours of breast tumors from the transverse, coronal, and sagittal planes. The obtained contours are further utilized to generate appropriate three-dimensional (3D) contours. Twenty breast tumor cases were evaluated and the simulation results show that the proposed contouring method was an efficient method for delineating 3D contours of breast tumors in MRI.
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Becsek A, Tzanidakis N, Blanco M, Bollwein H. Transrectal three-dimensional fetal volumetry and crown-rump length measurement during early gestation in mares: Intra- and inter-observer reliability and agreement. Theriogenology 2018; 126:266-271. [PMID: 30590249 DOI: 10.1016/j.theriogenology.2018.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 11/08/2018] [Accepted: 11/15/2018] [Indexed: 10/27/2022]
Abstract
The aim of this study was to investigate if transrectal three-dimensional (3D) ultrasound is a reliable technique to measure equine fetal volume (FV) during early gestation in mares. In total 149 warmblood mares were examined once transrectally on days 45 ± 1 of pregnancy with a portable 3D ultrasound device (Voluson® i, GE Healthcare, Zipf, Austria). The following measurements were performed: Two-dimensional (2D) and 3D crown-rump length (CRL), FV using Virtual Organ Computer-aided AnaLysis (VOCAL™) software with rotational angles of 6° and 30°. To analyze intra- and inter-observer reliability (intraclass correlation coefficient (ICC)) and agreement (Bland-Altman's limits of agreement (LoA)) of FV measurements, images from 60 horse fetuses were selected and repeatedly analyzed by the same examiner (A) and by a second examiner (B). The time for each ultrasound examination (2D and 3D) and for the FV measurements was recorded. The 3D measured CRL was larger (P < 0.001) than the 2D CRL. Repeated measurements of 3D CRL showed a higher reliability (ICC = 0.91 (0.88-0.94), P < 0.001) and agreement (mean = 0.13%, 95% LoA: 7.45 to +7.19) compared to reliability (ICC = 0.50 (0.36-0.61), P < 0.001) and agreement (mean = -1.54%, 95% LoA: 23.29 to +20.21) of the CRL measurement in 2D mode. For intra-observer examinations, reliability was highest when using a rotational angle of 30° (ICC = 0.98 (0.97-0.99), P < 0.001). The inter-observer reliability of 3D measurements was good (ICC = 0.85 (0.67-0.92), P < 0.001). The extra time needed to perform the 3D scan ranged from 1 to 9 min and FV measurements lasted 03:30 ± 00:46 and 08:10 ± 01:05, for rotational angles of 30° and 6°, respectively. In conclusion, this study showed a high level of intra- and inter-observer reliability and agreement for FV measurements using VOCAL™. Furthermore, the 6° and 30° rotational angles can be used interchangeably, but test duration, reliability and agreement were better with the 30° rotational step method. The CRL measurements obtained with 3D mode probably reflects the true CRL, compared to the 2D measured CRL.
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Affiliation(s)
- Angela Becsek
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland.
| | - Nikolaos Tzanidakis
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland.
| | - Miguel Blanco
- Lewitz Stud, Lewitzhof 1, 19306, Neustadt-Glewe, Germany.
| | - Heinrich Bollwein
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland.
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12
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Liu J, Chai Y, Yu Y, Liu L. The value of 3-dimensional color Doppler in predicting intraoperative hemorrhage for cesarean scar pregnancy. Medicine (Baltimore) 2018; 97:e11969. [PMID: 30113503 PMCID: PMC6113015 DOI: 10.1097/md.0000000000011969] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 07/27/2018] [Indexed: 11/25/2022] Open
Abstract
The aim of this study is to evaluate the efficacy of 3-dimensional (3D) ultrasonography and 3D color power Doppler ultrasound in the management of cesarean scar pregnancy (CSP).A case-control study enrolled 190 CSP patients who underwent uterine artery embolization (UAE) in combination with dilatation and curettage (D&C). The maximum diameter of gestational sac or CSP mass, uterine scar thickness, and resistance index (RI) were measured by 2D ultrasound. The lesion volume, vascular index (VI), flow index (FI), blood vessels, and blood flow index (VFI) were assessed by 3D ultrasound. The changes of these parameters before and after UAE were analyzed. Then, the patients were divided into bleeding group and control group according to the intraoperative hemorrhage during D&C to access and compare the significance of 2D and 3D parameters in intraoperative hemorrhage.The mean VI and the mean VFI were significantly reduced after embolization (P < .01). In the bleeding group, the lesion volume and diameter of gestational sac or CSP mass were significantly larger, VI and VFI were significantly higher, the uterine scar thickness was thinner, and RI was lower (P < .05). The best indicator for prediction of massive intraoperative bleeding was the VI with an area under the curve of 0.870, the best cut-off value of VI was 7.500, and the sensitivity and specificity were 88.2% and 82.4%, respectively. In comparing the receiver operating characteristic curves among 2D and 3D ultrasound parameters, the diagnostic efficacy of lesion volume was significantly higher than maximum diameter (P < .001). The diagnostic efficacy of VI was significantly higher than maximum diameter (P = .020) and RI (P = .011).UAE reduces the number of vessels and the blood flow perfusion obviously; however, it does not reduce lesion size or increases myometrial thickness. Three-dimensional ultrasonography and power Doppler, especially VI, lesion volume may be helpful in predicting excessive bleeding during D&C after UAE.
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MESH Headings
- Adult
- Area Under Curve
- Blood Loss, Surgical
- Case-Control Studies
- Cesarean Section/adverse effects
- Cicatrix/complications
- Dilatation and Curettage/adverse effects
- Female
- Humans
- Imaging, Three-Dimensional/methods
- Imaging, Three-Dimensional/statistics & numerical data
- Predictive Value of Tests
- Pregnancy
- Pregnancy, Ectopic/diagnostic imaging
- Pregnancy, Ectopic/etiology
- Pregnancy, Ectopic/surgery
- ROC Curve
- Reference Values
- Ultrasonography, Doppler, Color/methods
- Ultrasonography, Doppler, Color/statistics & numerical data
- Uterine Artery Embolization/adverse effects
- Young Adult
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13
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Li S, Yu D, Ji H, Zhao B, Ji L, Leng X. In vivo degradation and neovascularization of silk fibroin implants monitored by multiple modes ultrasound for surgical applications. Biomed Eng Online 2018; 17:87. [PMID: 29925373 PMCID: PMC6011526 DOI: 10.1186/s12938-018-0478-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 04/17/2018] [Indexed: 11/16/2022] Open
Abstract
Background In this paper we aimed to investigate the neovascularization and biodegradation of the silk fibroin in vivo using multiple modes ultrasound, including two-dimensional, three-dimensional and contrast-enhanced ultrasound by quantifying the echo intensity, volume and contrast enhancement of the silk fibroin implants. Method A total of 56 male Wistar rats were randomly divided into two groups and 4%(w/v) silk hydrogels were injected subcutaneously at hind limb or upper back of the rats respectively to compare the biodegradation rate in different sites of the body. The implants were observed at day 0, 4, 8, 12, 16, 18, 20 with multiple modes ultrasound. Results The echo intensity of silk fibroin implants increased and the volume decreased gradually, and complete degradation was confirmed 18 and 20 days after subcutaneous implantation at the upper back and at the hind limb respectively. This demonstrated that the silk fibroin embedded in the upper back degraded slightly faster than that in the hind limb. Additionally, the neovascularization revealed by the contrast enhancement values of CEUS showed that there was a relatively low enhancement (< 5 dB) during day 4 to day 16, followed by moderate enhancement at day 18 (5–20 dB), and a significant enhancement at day 20 (> 40 dB). Conclusion This study suggests that multiple modes ultrasound imaging could be an ideal method to evaluate the degradation and neovascularization of biomaterial implants in vivo for surgical applications.
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Affiliation(s)
- Shouqiang Li
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang Province, China.,The Key Laboratories of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang Province, China
| | - Dandan Yu
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang Province, China
| | - Huan Ji
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang Province, China
| | - Baocun Zhao
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang Province, China
| | - Lili Ji
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang Province, China
| | - Xiaoping Leng
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang Province, China. .,The Key Laboratories of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang Province, China.
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14
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Automated Techniques for the Interpretation of Fetal Abnormalities: A Review. Appl Bionics Biomech 2018; 2018:6452050. [PMID: 29983738 PMCID: PMC6015700 DOI: 10.1155/2018/6452050] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 04/07/2018] [Accepted: 05/10/2018] [Indexed: 11/17/2022] Open
Abstract
Ultrasound (US) image segmentation methods, focusing on techniques developed for fetal biometric parameters and nuchal translucency, are briefly reviewed. Ultrasound medical images can easily identify the fetus using segmentation techniques and calculate fetal parameters. It can timely find the fetal abnormality so that necessary action can be taken by the pregnant woman. Firstly, a detailed literature has been offered on fetal biometric parameters and nuchal translucency to highlight the investigation approaches with a degree of validation in diverse clinical domains. Then, a categorization of the bibliographic assessment of recent research effort in the segmentation field of ultrasound 2D fetal images has been presented. The fetal images of high-risk pregnant women have been taken into the routine and continuous monitoring of fetal parameters. These parameters are used for detection of fetal weight, fetal growth, gestational age, and any possible abnormality detection.
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15
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Gao Y, Yan K, Yang L, Cheng G, Zhou W. Biometry reference range of the corpus callosum in neonates: An observational study. Medicine (Baltimore) 2018; 97:e11071. [PMID: 29901615 PMCID: PMC6024229 DOI: 10.1097/md.0000000000011071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aims to present the reference range of corpus callosum by ultrasound imaging in neonates and to develop a clinically feasible screening method for congenital abnormalities of corpus callosum.An observational study was conducted between January 2015 and July 2016; 2D and 3D ultrasound evaluations were conducted and virtural organ computer-aided analysis was applied in the volume calculation of corpus callosum. The following parameters were measured: thickness of the rostum, thickness of the genu, thickness of the body, thickness of the splenium, anterior-posterior distance, true length of the corpus callosum and the volume of the corpus callosum. Inter- and intraobserver agreement was also evaluated. The corrected gestational age was between 38+0 and 47+2 weeks. The least-mean-square method was used to create the growth curve for each parameter.Complete data sets were available in 317 neonates, ranging from 0 to 28 days of age. Reference values from the 1st to 99th percentiles were provided. All parameters showed a nonlinear growth trend with age. Inter- and intraobserver agreement was excellent for 2D and 3D parameters.Our results suggested that computer techniques can assist in the volume assessment of corpus callosum. The 2D and 3D ultrasound data of 7 morphologic parameters may facilitate the identification of corpus callosum anomalies based on a large population.
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Affiliation(s)
| | | | - Lin Yang
- Clinical Genetic Center, Children's Hospital of Fudan University, Shanghai, China
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16
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Albers MEWA, Buisman ETIA, Kahn RS, Franx A, Onland-Moret NC, de Heus R. Intra- and interobserver agreement for fetal cerebral measurements in 3D-ultrasonography. Hum Brain Mapp 2018; 39:3277-3284. [PMID: 29637664 DOI: 10.1002/hbm.24076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/27/2018] [Accepted: 03/29/2018] [Indexed: 12/30/2022] Open
Abstract
The aim of this study is to evaluate intra- and interobserver agreement for measurement of intracranial, cerebellar, and thalamic volume with the Virtual Organ Computer-aided AnaLysis (VOCAL) technique in three-dimensional ultrasound images, in comparison to two-dimensional measurements of these brain structures. Three-dimensional ultrasound images of the brains of 80 fetuses at 20-24 weeks' gestational age were obtained from YOUth, a Dutch prospective cohort study. Two observers performed offline measurement of the occipitofrontal diameter, intracranial volume, transcerebellar diameter, cerebellar volume, and thalamic width, area, and volume, independently. VOCAL was used for calculation of the volumes. The two-way random, single measures intraclass correlation coefficient (ICC) was used for analysis of agreement and Bland-Altman plots were configured. Intra- and interobserver agreement was almost perfect for occipitofrontal diameter (intra ICC 0.88, 95% CI 0.82-0.92; inter ICC 0.91, 95% CI 0.85-0.94), intracranial volume (intra ICC 0.96, 95% CI 0.91-0.98; inter ICC 0.97, 95% CI 0.96-0.98) and transcerebellar diameter (intra ICC 0.91, 95% CI 0.86-0.94; inter ICC 0.86, 95% CI 0.78-0.910). For cerebellar volume, the intraobserver agreement was almost perfect (0.85, 95% CI 0.76-0.90), whereas the interobserver agreement was substantial (0.75, 95% CI 0.44-0.88). Agreement was only moderate for thalamic measurements. Bland-Altman plots for the volume measurements are normally distributed with acceptable mean differences and 95% limits of agreement. The intra- and interobserver agreement of the measurement of intracranial and cerebellar volume with VOCAL was almost perfect. These measurements are therefore reliable, and can be used to investigate fetal brain development. Thalamic measurements are not reliable enough.
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Affiliation(s)
- Maria E W A Albers
- Division of Woman and Baby, University Medical Center Utrecht, Utrecht University, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Erato T I A Buisman
- Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands
| | - René S Kahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, The Netherlands.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Arie Franx
- Division of Woman and Baby, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Roel de Heus
- Division of Woman and Baby, University Medical Center Utrecht, Utrecht University, The Netherlands
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17
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Scala C, Leone Roberti Maggiore U, Barra F, Venturini P, Ferrero S. Norethindrone acetate versus extended-cycle oral contraceptive (Seasonique ® ) in the treatment of endometriosis symptoms: A prospective open-label comparative study. Eur J Obstet Gynecol Reprod Biol 2018; 222:89-94. [DOI: 10.1016/j.ejogrb.2018.01.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/29/2017] [Accepted: 01/16/2018] [Indexed: 12/01/2022]
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18
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Ahmed AI, Aldhaheri SR, Rodriguez-Kovacs J, Narasimhulu D, Putra M, Minkoff H, Haberman S. Sonographic Measurement of Cervical Volume in Pregnant Women at High Risk of Preterm Birth Using a Geometric Formula for a Frustum Versus 3-Dimensional Automated Virtual Organ Computer-Aided Analysis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:2209-2217. [PMID: 28586106 DOI: 10.1002/jum.14253] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 02/02/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To compare cervical volume measurements by 3-dimensional (3D) sonography using Virtual Organ computer-aided analysis (VOCAL; GE Healthcare, Milwaukee, WI) versus a manual method using a geometric formula for a frustum. METHODS We included 142 asymptomatic pregnant women at 16 to 24 weeks gestation at high risk for preterm birth. With a Voluson 730 Expert system (GE Healthcare), they underwent 2-dimensional (2D) transvaginal sonographic cervical length measurements and 3D cervical volume acquisition. The stored volumes were processed by VOCAL on a surface tablet. Cervical volume was manually calculated from the 2D images by using the formula V = 1/3 × π × h × (r12 + r22 + r1 × r2), where V represents cervical volume; π was approximated as 3.14159; h, cervical length; r1, radius at the internal os; and r2, radius at the external os. RESULTS Cervical volume was lower when obtained manually than by VOCAL, with a coefficient of variation of 30%, a mean difference of 10.1 ± 14.9 cm3 (P < .0001), and a poor interclass correlation coefficient of 0.62 (95% confidence interval [CI], 0.31 to 0.78). Both methods had good reproducibility; however, VOCAL had wider limits of agreement. A positive correlation was found between both methods (r = 0.63; P < .0001). No correlation was found between cervical length by 2D transvaginal ultrasound and cervical volume by the VOCAL technique (r = 0.06; 95% CI, -0.10 to 0.22) or cervical volume by the manual method (r = 0.2; 95% CI, 0.08 to 0.39). CONCLUSIONS The cervix represents a frustum (truncated cone, r1 is not equal to r2) in shape rather than a cylinder. Both methods are reproducible; VOCAL is less reliable but provides higher values of cervical volume.
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Affiliation(s)
- Ahmed I Ahmed
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
- Department of Medical Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Sarah R Aldhaheri
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, USA
- Department of Obstetrics and Gynecology, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - Javier Rodriguez-Kovacs
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Deepa Narasimhulu
- Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York, USA
| | - Manesha Putra
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Howard Minkoff
- Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York, USA
| | - Shoshana Haberman
- Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York, USA
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19
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Guo Y, Liu X, Gu X, Zhang Y, Sun L, He Y. Fetal lung volume and pulmonary artery changes in congenital heart disease with decreased pulmonary blood flow: Quantitative ultrasound analysis. Echocardiography 2017; 35:85-89. [PMID: 28994140 DOI: 10.1111/echo.13724] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Yong Guo
- Department of Ultrasound; Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease; Beijing An Zhen Hospital; Capital Medical University; Beijing China
| | - Xiaowei Liu
- Department of Ultrasound; Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease; Beijing An Zhen Hospital; Capital Medical University; Beijing China
| | - Xiaoyan Gu
- Department of Ultrasound; Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease; Beijing An Zhen Hospital; Capital Medical University; Beijing China
| | - Ye Zhang
- Department of Ultrasound; Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease; Beijing An Zhen Hospital; Capital Medical University; Beijing China
| | - Lin Sun
- Department of Ultrasound; Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease; Beijing An Zhen Hospital; Capital Medical University; Beijing China
| | - Yihua He
- Department of Ultrasound; Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease; Beijing An Zhen Hospital; Capital Medical University; Beijing China
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20
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Inter-observer variability in the assessment of ultrasound features of polycystic ovaries. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2017. [DOI: 10.1016/j.mefs.2017.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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21
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Choi YR, Kim JH, Park SJ, Hur BY, Han JK. Therapeutic response assessment using 3D ultrasound for hepatic metastasis from colorectal cancer: Application of a personalized, 3D-printed tumor model using CT images. PLoS One 2017; 12:e0182596. [PMID: 28797089 PMCID: PMC5552302 DOI: 10.1371/journal.pone.0182596] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 07/23/2017] [Indexed: 12/13/2022] Open
Abstract
Background & aims To evaluate accuracy and reliability of three-dimensional ultrasound (3D US) for response evaluation of hepatic metastasis from colorectal cancer (CRC) using a personalized 3D-printed tumor model. Methods Twenty patients with liver metastasis from CRC who underwent baseline and after chemotherapy CT, were retrospectively included. Personalized 3D-printed tumor models using CT were fabricated. Two radiologists measured volume of each 3D printing model using 3D US. With CT as a reference, we compared difference between CT and US tumor volume. The response evaluation was based on Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Results 3D US tumor volume showed no significant difference from CT volume (7.18 ± 5.44 mL, 8.31 ± 6.32 mL vs 7.42 ± 5.76 mL in CT, p>0.05). 3D US provided a high correlation coefficient with CT (r = 0.953, r = 0.97) as well as a high inter-observer intraclass correlation (0.978; 0.958–0.988). Regarding response, 3D US was in agreement with CT in 17 and 18 out of 20 patients for observer 1 and 2 with excellent agreement (κ = 0.961). Conclusions 3D US tumor volume using a personalized 3D-printed model is an accurate and reliable method for the response evaluation in comparison with CT tumor volume.
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Affiliation(s)
- Ye Ra Choi
- Department of Radiology, Boramae Medical Center, Seoul, Korea
| | - Jung Hoon Kim
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
- Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
| | - Sang Joon Park
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Bo Yun Hur
- Department of Radiology, National Cancer Center, Gyeonggi-do, Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
- Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
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22
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Hettfleisch K, Bernardes LS, Carvalho MA, Pastro LDM, Vieira SE, Saldiva SRDM, Saldiva P, Francisco RPV. Short-Term Exposure to Urban Air Pollution and Influences on Placental Vascularization Indexes. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:753-759. [PMID: 27384326 PMCID: PMC5381983 DOI: 10.1289/ehp300] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 05/26/2016] [Accepted: 06/14/2016] [Indexed: 05/05/2023]
Abstract
BACKGROUND It has been widely demonstrated that air pollution can affect human health and that certain pollutant gases lead to adverse obstetric outcomes, such as preeclampsia and fetal growth restriction. OBJECTIVES We evaluated the influence of individual maternal exposure to air pollution on placental volume and vascularization evaluated in the first trimester of pregnancy. METHODS This was a cross-sectional study on low-risk pregnant women living in São Paulo, Brazil. The women carried passive personal NO2 and O3 monitors in the week preceding evaluation. We employed the virtual organ computer-aided analysis (VOCAL) technique using three-dimensional power Doppler ultrasound to evaluate placental volume and placental vascular indexes [vascularization index (VI), flow index (FI), and vascularization flow index (VFI)]. We analyzed the influence of pollutant levels on log-transformed placental vascularization and volume using multiple regression models. RESULTS We evaluated 229 patients. Increased NO2 levels had a significant negative association with log of VI (p = 0.020 and beta = -0.153) and VFI (p = 0.024 and beta = -0.151). NO2 and O3 had no influence on the log of placental volume or FI. CONCLUSIONS NO2, an estimator of primary air pollutants, was significantly associated with diminished VI and VFI in the first trimester of pregnancy.
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Affiliation(s)
| | - Lisandra Stein Bernardes
- Department of Obstetrics and Gynecology, and
- Address correspondence to L.S. Bernardes, The Procriar Study Group, Department of Obstetrics and Gynecology, School of Medicine at the University of São Paulo, São Paulo, Brazil; 255, Av. Dr. Enéas de Carvalho Aguiar, São Paulo, Brazil 05403-900. Telephone: 551126616209. E-mail:
| | - Mariana Azevedo Carvalho
- Department of Obstetrics and Gynecology, and
- Address correspondence to L.S. Bernardes, The Procriar Study Group, Department of Obstetrics and Gynecology, School of Medicine at the University of São Paulo, São Paulo, Brazil; 255, Av. Dr. Enéas de Carvalho Aguiar, São Paulo, Brazil 05403-900. Telephone: 551126616209. E-mail:
| | | | | | | | - Paulo Saldiva
- Institute of Advanced Studies of the University of São Paulo, São Paulo, Brazil
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Saravelos SH, Jayaprakasan K, Ojha K, Li TC. Assessment of the uterus with three-dimensional ultrasound in women undergoing ART. Hum Reprod Update 2017; 23:188-210. [PMID: 28007752 DOI: 10.1093/humupd/dmw040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A detailed assessment of the uterus forms a pivotal part of the ART treatment process. The emergence of three-dimensional ultrasound (3D US) has provided clinicians with a highly powerful tool in this respect. Assessments with 3D US range from the reconstruction of anatomical planes elusive to conventional US, to the objective measurement of anatomical volumes and vascularization parameters. However, despite the ever increasing number of publications emerging in the literature, the question of which aspects of 3D US are of most clinical value remains a topic of debate. OBJECTIVE AND RATIONALE The objective of this review is to dissect which aspects of the 3D US assessment of the uterus are supported by a strong level of evidence to date, and should therefore be incorporated into current routine clinical practice. SEARCH METHODS We conducted a systematic search of the PubMed database up to May 2016, using a combination of text words and Medical Subject Headings (MeSH) pertaining to the 3D US assessment of the uterus. All articles published in the English language were screened to ascertain relevance to women of reproductive age; further citations were retrieved through manual reference list searching. OUTCOMES A multitude of predominantly observational studies were identified, which concerned a vast variety of 3D US uterine assessments. All articles unequivocally praised the non-invasive, cost-effective, highly acceptable and objective nature of 3D US. Studies regarding the value of assessing the endometrial volume and vascularization prior to embryo transfer appeared conflicting and inconsistent. Studies regarding the imaging of uterine pathology and identification of intratubal and intrauterine devices consistently reported high rates of diagnostic accuracy. A recent RCT did not show an improvement in clinical outcomes when comparing 3D versus 2D US during embryo transfer. However, preliminary studies suggested that 3D US is superior in determining the site of implantation, particularly in ambiguous cases such as interstitial and angular pregnancies. Finally, pilot studies have suggested that the further integration of 3D and possibly 4D US with surgical interventions of the uterus may be a promising prospect. WIDER IMPLICATIONS 3D US may prove to be an invaluable tool in the assessment of the uterus within the context of ART. Currently, the aim should be to highlight the aspects of 3D US that are most evidence-based and valuable for patients, and to incorporate these into routine clinical practice.
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Affiliation(s)
- Sotirios H Saravelos
- Assisted Reproductive Technology Unit, Department of Obstetrics & Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Shatin, Hong Kong
| | - Kannamannadiar Jayaprakasan
- Assisted Reproductive Technology Unit, Department of Obstetrics & Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Shatin, Hong Kong
| | - Kamal Ojha
- Assisted Reproductive Technology Unit, Department of Obstetrics & Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Shatin, Hong Kong
| | - Tin-Chiu Li
- Assisted Reproductive Technology Unit, Department of Obstetrics & Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Shatin, Hong Kong
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Benavente‐Fernandez I, Lubián‐Gutierrez M, Jimenez‐Gomez G, Lechuga‐Sancho AM, Lubián‐López SP. Ultrasound lineal measurements predict ventricular volume in posthaemorrhagic ventricular dilatation in preterm infants. Acta Paediatr 2017; 106:211-217. [PMID: 27783429 DOI: 10.1111/apa.13645] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 10/24/2016] [Indexed: 11/30/2022]
Abstract
AIM Posthaemorrhagic ventricular dilatation (PHVD) is monitored by conventional two-dimensional ultrasound (2DUS). The aims of this study were to determine the volume of the lateral ventricles using three-dimensional ultrasound (3DUS) in preterm infants with PHVD and to evaluate the relationship between volume and linear measurements. METHODS Serial 2DUSs and 3DUSs were performed on preterm infants with PHVD admitted to the neonatal intensive care unit at Puerta del Mar Hospital, Cádiz, Spain, from January 2013 to December 2014. The ventricular index, anterior horn width and thalamo-occipital distance were used as ventricular lineal measurements. Ventricular volume was calculated offline. RESULTS Serial ultrasounds from seven preterm infants were measured. Each linear measurement was significantly associated with volume, and an equation was obtained through a significant multilevel mixed-effects lineal regression model: ventricular volume (cm3 ) = -11.02 + 0.668*VI + 0.817*AHW + 0.256*TOD. Intra-observer and interobserver agreement was excellent with an intraclass correlation coefficient of 0.99. CONCLUSION Lateral ventricular volumes of preterm infants with PHVD could be reliably determined using 3DUS. Ventricular volume could be accurately estimated using three lineal measurements. More studies are needed to address the importance of volume determination in PHVD.
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Affiliation(s)
- Isabel Benavente‐Fernandez
- Neonatology Department “Puerta del Mar” University Hospital Cadiz Spain
- Fundación Nene (Neonatal Neurology Research Group) Madrid Spain
| | | | | | | | - Simon P. Lubián‐López
- Neonatology Department “Puerta del Mar” University Hospital Cadiz Spain
- Fundación Nene (Neonatal Neurology Research Group) Madrid Spain
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Kim D, Epperson CN, Ewing G, Appleby D, Sammel MD, Wang E. Methodology for Using 3-Dimensional Sonography to Measure Fetal Adrenal Gland Volumes in Pregnant Women With and Without Early Life Stress. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:2029-2037. [PMID: 27562975 DOI: 10.7863/ultra.15.10046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 12/23/2015] [Indexed: 06/06/2023]
Abstract
Fetal adrenal gland volumes on 3-dimensional sonography have been studied as potential predictors of preterm birth. However, no consistent methodology has been published. This article describes the methodology used in a study that is evaluating the effects of maternal early life stress on fetal adrenal growth to allow other researchers to compare methodologies across studies. Fetal volumetric data were obtained in 36 women at 20 to 22 and 28 to 30 weeks' gestation. Two independent examiners measured multiple images of a single fetal adrenal gland from each sonogram. Intra- and inter-rater consistency was examined. In addition, fetal adrenal volumes between male and female fetuses were reported. The intra- and inter-rater reliability was satisfactory when the mean of 3 measurements from each rater was used. At 20 weeks' gestation, male fetuses had larger average adjusted adrenal volumes than female fetuses (mean, 0.897 versus 0.638; P = .004). At 28 weeks' gestation, the fetal weight was more influential in determining values for adjusted fetal adrenal volume (0.672 for male fetuses versus 0.526 for female fetuses; P = .034). This article presents a methodology for assessing fetal adrenal volume using 3-dimensional sonography that can be used by other researchers to provide more consistency across studies.
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Affiliation(s)
- Deborah Kim
- Penn Center for Women's Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania USA, Penn PROMOTES Research on Sex and Gender in Health, University of Pennsylvania, Philadelphia, Pennsylvania USA
| | - C Neill Epperson
- Penn Center for Women's Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania USA, Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania USA, Penn PROMOTES Research on Sex and Gender in Health, University of Pennsylvania, Philadelphia, Pennsylvania USA
| | - Grace Ewing
- Penn Center for Women's Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania USA, Penn PROMOTES Research on Sex and Gender in Health, University of Pennsylvania, Philadelphia, Pennsylvania USA
| | - Dina Appleby
- Penn Center for Women's Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania USA, Penn PROMOTES Research on Sex and Gender in Health, University of Pennsylvania, Philadelphia, Pennsylvania USA
| | - Mary D Sammel
- Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania USA, Penn PROMOTES Research on Sex and Gender in Health, University of Pennsylvania, Philadelphia, Pennsylvania USA
| | - Eileen Wang
- Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania USA
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You SH, Suh SI, Ryoo IS, Son GR, Lee YH, Seo HS, Lee NJ, Seol HY. Assessing the accuracy and reliability of ultrasonographic three-dimensional parathyroid volume measurement in a patient with secondary hyperparathyroidism: a comparison with the two-dimensional conventional method. Ultrasonography 2016; 36:17-24. [PMID: 27457337 PMCID: PMC5207356 DOI: 10.14366/usg.16022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 05/30/2016] [Accepted: 06/08/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose The purpose of this study was to investigate the accuracy and reliability of the semi-automated ultrasonographic volume measurement tool, virtual organ computer-aided analysis (VOCAL), for measuring the volume of parathyroid glands. Methods Volume measurements for 40 parathyroid glands were performed in patients with secondary hyperparathyroidism caused by chronic renal failure. The volume of the parathyroid glands was measured twice by experienced radiologists by two-dimensional (2D) and three-dimensional (3D) methods using conventional sonograms and the VOCAL with 30°angle increments before parathyroidectomy. The specimen volume was also measured postoperatively. Intraclass correlation coefficients (ICCs) and the absolute percentage error were used for estimating the reproducibility and accuracy of the two different methods. Results The ICC value between two measurements of the 2D method and the 3D method was 0.956 and 0.999, respectively. The mean absolute percentage error of the 2D method and the 3D VOCAL technique was 29.56% and 5.78%, respectively. For accuracy and reliability, the plots of the 3D method showed a more compact distribution than those of the 2D method on the Bland-Altman graph. Conclusion The rotational VOCAL method for measuring the parathyroid gland is more accurate and reliable than the conventional 2D measurement. This VOCAL method could be used as a more reliable follow-up imaging modality in a patient with hyperparathyroidism.
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Affiliation(s)
- Sung-Hye You
- Department of Radiology, Korea University Anam Hospital, Seoul, Korea
| | - Sang-Il Suh
- Department of Radiology, Korea University Guro Hospital, Seoul, Korea
| | - In-Seon Ryoo
- Department of Radiology, Korea University Guro Hospital, Seoul, Korea
| | - Gyu-Ri Son
- Department of Radiology, Korea University Anam Hospital, Seoul, Korea
| | - Young-Hen Lee
- Department of Radiology, Korea University Ansan Hospital, Ansan, Korea
| | - Hyung Suk Seo
- Department of Radiology, Korea University Ansan Hospital, Ansan, Korea
| | - Nam Joon Lee
- Department of Radiology, Korea University Anam Hospital, Seoul, Korea
| | - Hae Young Seol
- Department of Radiology, Korea University Guro Hospital, Seoul, Korea
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Sonographic evaluation of polycystic ovaries. Best Pract Res Clin Obstet Gynaecol 2016; 37:25-37. [PMID: 27118252 DOI: 10.1016/j.bpobgyn.2016.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 02/27/2016] [Indexed: 10/22/2022]
Abstract
The morphological features of the ovaries in women with polycystic ovary syndrome (PCOS) have been well described by ultrasound imaging technology. These include enlarged ovary size, multiple small follicles of similar size, increased ovarian stromal volume and echogenicity, peripheral distribution of the follicles, and higher stromal blood flow. Ultrasound identification of the presence of polycystic ovarian morphology (PCOM) has been recognized as a component of PCOS diagnosis. With the advance of ultrasound technology, new definition has been proposed recently. There is, however, a paucity of data for the ovarian morphology in normal and PCOS adolescents. Magnetic resonance imaging has the potential to be an alternative imaging modality for diagnosing PCOM in adolescence.
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Duan J, Chabot-Lecoanet AC, Perdriolle-Galet E, Christov C, Hossu G, Cherifi A, Morel O. Utero-placental vascularisation in normal and preeclamptic and intra-uterine growth restriction pregnancies: third trimester quantification using 3D power Doppler with comparison to placental vascular morphology (EVUPA): a prospective controlled study. BMJ Open 2016; 6:e009909. [PMID: 27033959 PMCID: PMC4823389 DOI: 10.1136/bmjopen-2015-009909] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Preeclampsia (PE) and intra-uterine growth restriction (IUGR) are two major pregnancy complications related to chronic utero-placental hypoperfusion. Three-dimensional power Doppler (3DPD) angiography has been used for the evaluation of utero-placental vascularisation and three vascular indices have been calculated: the vascularisation index (VI), flow index (FI) and vascularisation-FI (VFI). However, several technical endpoints hinder the clinical use of 3DPD as physical characteristics and machine settings may affect 3DPD indices, and so its clinical significance is not yet clear. OBJECTIVES The primary objective is to better understand the clinical significance of 3DPD indices by evaluating the relationship between these indices and placental morphometry. Secondary objectives are (i) to determine the impact of machine settings and physical characteristics on 3DPD indices, and (ii) to evaluate physio-pathological placental vascularisation patterns. METHODS AND ANALYSIS This is a prospective controlled study. We expect to include 112 women: 84 with normal pregnancies and 28 with PE and/or IUGR (based on our former cohort study on 3DPD indices for PE and/or IUGR prediction (unpublished data)). Within 72 h before planned or semi-urgent caesarean section, utero-placental 3DPD images with five different machine settings will be acquired. Placentas will be collected and examined after surgery and stereological indices (volume density, surface density, length density) calculated. The 3DPD indices (VI, FI and VFI) of the placenta and adjacent myometrium will be calculated. Correlation between Doppler and morphological indices will be evaluated by Pearson or Spearman tests. Agreement between 3DPD indices and morphological indices will be assessed by Bland and Altman plots. The impact of Doppler settings and maternal characteristics on 3DPD indices will be evaluated with a multivariate linear regression model. ETHICS The study and related consent forms have been approved by the French Ethics Committee (CPP, Comité de Protection des Personnes) Est III on 4 March 2014.
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Affiliation(s)
- Jie Duan
- IADI, Inserm U947, University of Lorraine, Nancy, France
- Pôle de Gynécologie-Obstétrique, Service d'Obstétrique et Médecine Fœtale, CHRU Nancy, Nancy, France
| | - Anne-Claire Chabot-Lecoanet
- IADI, Inserm U947, University of Lorraine, Nancy, France
- Pôle de Gynécologie-Obstétrique, Service d'Obstétrique et Médecine Fœtale, CHRU Nancy, Nancy, France
| | - Estelle Perdriolle-Galet
- IADI, Inserm U947, University of Lorraine, Nancy, France
- Pôle de Gynécologie-Obstétrique, Service d'Obstétrique et Médecine Fœtale, CHRU Nancy, Nancy, France
| | - Christophe Christov
- Service Commun de Microscopie, Faculté de Médecine, University of Lorraine, Vandoeuvre-Lès-Nancy, France
- Laboratory of Fetal and Placental Pathology, CHRU Nancy, Nancy, France
| | | | | | - Olivier Morel
- IADI, Inserm U947, University of Lorraine, Nancy, France
- Pôle de Gynécologie-Obstétrique, Service d'Obstétrique et Médecine Fœtale, CHRU Nancy, Nancy, France
- PremUp Foundation, Paris, France
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Larsen ML, Naver KV, Kjaer MM, Jorgensen FS, Nilas L. Reproducibility of 3-Dimensional Ultrasound Measurements of Placental Volume at Gestational Ages 11 - 14 Weeks. Facts Views Vis Obgyn 2015; 7:203-209. [PMID: 27729965 PMCID: PMC5058409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate the reproducibility of placental volume using three-dimensional ultrasound. METHODS The VOCAL (Virtual Organ Computer-aided AnaLysis) technique involves rotating an image of an object along an established axis using predefined angles. This provides a number of sections to measure manually, resulting in the object being displayed with an estimated placental volume. Four predefined angles 30°, 15°, 9°, and 6°, creating 6, 12, 20 and 30 sections, respectively. Measurements of placenta volumes in 21 women with singleton pregnancies were performed at gestational age 11-14 weeks by a single consultant in Foetal Medicine and later processed by two observers. The intraobserver reproducibility between all four angles was calculated as the mean Coefficient of Variation. Interobserver reproducibility was assessed by Interclass Correlation Coefficient (ICC), Limits of Agreement (LOA) and illustrated in Bland-Altman plots. RESULTS There was no significant difference in intraobserver variability between the four angles, p = 0.19, but a trend towards a lower coefficient of variation with the smallest angle was observed. A high intraobserver reproducibility was found using the 6° angle (ICC = 0.918 (0.812 - 0.966) and 0.983 (0.960- 0.993), LOA = [-22.9- 22.5] and [-14.3 - 12.1]), but interobserver reproducibility showed a wide range of agreement (LOA = [-50.5- 34.8]), particularly in cases with u-shaped placentas. CONCLUSION The low interobserver reproducibility of VOCAL measurements of placentae requires significant differences between normal and abnormal cases if the technique should be implemented for clinical use.
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Affiliation(s)
- ML Larsen
- Department of Obstetrics and Gynaecology, University Hospital Hvidovre, University of Copenhagen, Denmark
| | - KV Naver
- Department of Obstetrics and Gynaecology, University Hospital Hvidovre, University of Copenhagen, Denmark
| | - MM Kjaer
- Department of Obstetrics and Gynaecology, University Hospital Hvidovre, University of Copenhagen, Denmark
| | - FS Jorgensen
- Department of Obstetrics and Gynaecology, University Hospital Hvidovre, University of Copenhagen, Denmark
| | - L Nilas
- Department of Obstetrics and Gynaecology, University Hospital Hvidovre, University of Copenhagen, Denmark
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Stevenson GN, Collins SL, Ding J, Impey L, Noble JA. 3-D Ultrasound Segmentation of the Placenta Using the Random Walker Algorithm: Reliability and Agreement. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:3182-3193. [PMID: 26341043 DOI: 10.1016/j.ultrasmedbio.2015.07.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 07/07/2015] [Accepted: 07/16/2015] [Indexed: 06/05/2023]
Abstract
Volumetric segmentation of the placenta using 3-D ultrasound is currently performed clinically to investigate correlation between organ volume and fetal outcome or pathology. Previously, interpolative or semi-automatic contour-based methodologies were used to provide volumetric results. We describe the validation of an original random walker (RW)-based algorithm against manual segmentation and an existing semi-automated method, virtual organ computer-aided analysis (VOCAL), using initialization time, inter- and intra-observer variability of volumetric measurements and quantification accuracy (with respect to manual segmentation) as metrics of success. Both semi-automatic methods require initialization. Therefore, the first experiment compared initialization times. Initialization was timed by one observer using 20 subjects. This revealed significant differences (p < 0.001) in time taken to initialize the VOCAL method compared with the RW method. In the second experiment, 10 subjects were used to analyze intra-/inter-observer variability between two observers. Bland-Altman plots were used to analyze variability combined with intra- and inter-observer variability measured by intra-class correlation coefficients, which were reported for all three methods. Intra-class correlation coefficient values for intra-observer variability were higher for the RW method than for VOCAL, and both were similar to manual segmentation. Inter-observer variability was 0.94 (0.88, 0.97), 0.91 (0.81, 0.95) and 0.80 (0.61, 0.90) for manual, RW and VOCAL, respectively. Finally, a third observer with no prior ultrasound experience was introduced and volumetric differences from manual segmentation were reported. Dice similarity coefficients for observers 1, 2 and 3 were respectively 0.84 ± 0.12, 0.94 ± 0.08 and 0.84 ± 0.11, and the mean was 0.87 ± 0.13. The RW algorithm was found to provide results concordant with those for manual segmentation and to outperform VOCAL in aspects of observer reliability. The training of an additional untrained observer was investigated, and results revealed that with the appropriate initialization protocol, results for observers with varying levels of experience were concordant. We found that with appropriate training, the RW method can be used for fast, repeatable 3-D measurement of placental volume.
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Affiliation(s)
- Gordon N Stevenson
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK; Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.
| | - Sally L Collins
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK; Fetal Medicine Unit, The Women's Centre, John Radcliffe Hospital, Oxford, UK
| | - Jane Ding
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK
| | - Lawrence Impey
- Fetal Medicine Unit, The Women's Centre, John Radcliffe Hospital, Oxford, UK
| | - J Alison Noble
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
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Abdel Fattah Abdel Moety G, Abdel Monem El Kattan E. Three-dimensional ultrasound using the VOCAL technique for estimation of reference values of fetal thigh volume in normally grown Egyptian fetuses from 20 to 41 weeks. J Matern Fetal Neonatal Med 2015; 29:2083-7. [DOI: 10.3109/14767058.2015.1075201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tonni G, Martins WP, Guimarães Filho H, Araujo Júnior E. Role of 3-D ultrasound in clinical obstetric practice: evolution over 20 years. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:1180-1211. [PMID: 25748522 DOI: 10.1016/j.ultrasmedbio.2014.12.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 12/10/2014] [Accepted: 12/11/2014] [Indexed: 06/04/2023]
Abstract
The use of 3-D ultrasound in obstetrics has undergone dramatic development over the past 20 years. Since the first publications on this application in clinical practice, several 3-D ultrasound techniques and rendering modes have been proposed and applied to the study of fetal brain, face and cardiac anatomy. In addition, 3-D ultrasound has improved calculations of the volume of fetal organs and limbs and estimations of fetal birth weight. And furthermore, angiographic patterns of fetal organs and the placenta have been assessed using 3-D power Doppler ultrasound quantification. In this review, we aim to summarize current evidence on the clinical relevance of these methodologies and their application in obstetric practice.
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Affiliation(s)
- Gabriele Tonni
- Department of Obstetrics and Gynecology, Guastalla Civil Hospital, ASL Reggio Emilia, Italy; Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil
| | - Wellington P Martins
- Department of Obstetrics and Gynecology, Ribeirão Preto School of Medicine, University of São Paulo (DGO-FMRP-USP), Ribeirão Preto-SP, Brazil
| | | | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil.
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Ergaz U, Goldstein I, Divon M, Weiner Z. A Preliminary Study of Three-dimensional Sonographic Measurements of the Fetus. Rambam Maimonides Med J 2015; 6:e0019. [PMID: 25973271 PMCID: PMC4422458 DOI: 10.5041/rmmj.10203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This study was aimed at establishing an ideal method for performing three-dimensional measurements of the fetus in order to improve the estimation of fetal weight. METHODS The study consisted of two phases. Phase I was a prospective cross-sectional study performed between 28 and 40 weeks' gestation. The study population (n=110) comprised low-risk singleton pregnancies who underwent a routine third-trimester sonographic estimation of fetal weight. The purpose of this phase was to establish normal values for the fetal abdominal and head volumes throughout the third trimester. Phase II was a prospective study that included patients admitted for an elective cesarean section or for induction of labor between 38 and 41 weeks' gestation (n=91). This phase of the study compared the actual birth weight to two- (2D) and three-dimensional (3D) measurements of the fetus. Conventional 2D ultrasound fetal biometry was performed measuring the biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur diaphysis length (FL). Volume estimates were computed utilizing Virtual Organ Computer-aided AnaLysis (VOCAL), and the correlation between measured volumes and actual neonatal weight was calculated. RESULTS Overall, this longitudinal study consisted of 110 patients between 28 and 41 weeks' gestation. Normal values were computed for the fetal abdomen and head volume throughout the third trimester. Ultrasound examination was performed within three days prior to delivery on 91 patients. A good correlation was found between birth weight and abdominal volume (r=0.77) and between birth weight and head volume (r=0.5). Correlation between bidimensional measurements and actual fetal weights was found to be comparable with previously published correlations. CONCLUSION Volume measurements of the fetus may improve the accuracy of estimating fetal size. Additional studies using different volume measurement of the fetus are necessary.
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Affiliation(s)
- Udi Ergaz
- Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
| | - Israel Goldstein
- Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
| | - Michael Divon
- Department of Obstetrics and Gynecology, Lenox Hill hospital, New York, NY, USA
| | - Zeev Weiner
- Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- To whom correspondence should be addressed. E-mail:
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Nardozza LMM, Passos AP, Araujo Júnior E, Bruns RF, Moron AF. Reference intervals of fetal cisterna magna volume by two-dimensional method using the multiplanar mode of three-dimensional ultrasonography. Radiol Bras 2015; 47:201-5. [PMID: 25741085 PMCID: PMC4337116 DOI: 10.1590/0100-3984.2013.1852] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 02/20/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To establish reference intervals for the fetal cisterna magna volume by means of two-dimensional (2D) method using the multiplanar mode of three-dimensional ultrasonography. MATERIALS AND METHODS Cross-sectional study with 224 healthy pregnant women between the 17th and 29th gestational weeks. The volume was automatically obtained by multiplying the three major axes in axial and sagittal planes by the constant 0.52. Polynomial regression was utilized to establish the correlation between fetal cisterna magna volume and gestational age, with adjustments by coefficient of determination (R(2)). Reliability and agreement were obtained by intraclass correlation coefficient (ICC) and limits of agreement, respectively. RESULTS Mean fetal cisterna volume with the 2D method ranged from 0.71 ± 0.19 cm(3) to 4.18 ± 0.75 cm(3) at the 17th and 29th weeks, respectively. The authors observed a good correlation between fetal cisterna magna volume and gestational age (R(2) = 0.67), excellent intraobserver reliability and agreement with ICC = 0.89 and limits of agreement 95% (-52.0; 51.8), respectively, and low interobserver reliability and agreement with ICC = 0.64 and limits of agreement 95% (-110.1; 84.6), respectively. CONCLUSION Reference intervals for fetal cisterna magna volume by means of 2D method using the multiplanar mode of three-dimensional ultrasonography were established and presented excellent intraobserver reliability and agreement.
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Affiliation(s)
- Luciano Marcondes Machado Nardozza
- Private Docents, Associate Professors, Obstetrics Department, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Ana Paula Passos
- Master, Physician Assistant at Clínica Fetalmed, Curitiba, PR, Brazil
| | - Edward Araujo Júnior
- Private Docents, Associate Professors, Obstetrics Department, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Rafael Frederico Bruns
- PhD, Associate Professor, Gynecology and Obstetrics Department, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | - Antonio Fernandes Moron
- Private Docent, Full Professor, Obstetrics Department, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
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Nieuwenhuis LL, Betjes HE, Hehenkamp WJK, Heymans MW, Brolmann HAM, Huirne JAF. The use of 3D power Doppler ultrasound in the quantification of blood vessels in uterine fibroids: feasibility and reproducibility. JOURNAL OF CLINICAL ULTRASOUND : JCU 2015; 43:171-178. [PMID: 25111971 DOI: 10.1002/jcu.22208] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 01/31/2014] [Accepted: 06/11/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND To evaluate the interobserver agreement and discriminating value of three-dimensional power Doppler ultrasound (3D PDUS) in patients with fibroids. METHODS An observational prospective cohort study in 19 patients with fibroids. 3D PDUS was performed by one examiner and evaluated by three independent examiners in order to evaluate various vascular parameters: vascular index (VI), flow index, and vascular flow index of the fibroid, the vascular capsule and of its highest vascular area, using both manual and automatic contour modes. The intraclass correlation coefficient and discriminating values were calculated. The correlation between VI and volume was studied using Kendall's Tau test. RESULTS In the manual contour mode, the VIs of the fibroid and of the vascular capsule had the highest interobserver agreements (intraclass correlation coefficients of 0.89 and 0.87, respectively). Both parameters seem to have good discriminating values, given the large range of these parameters between different fibroids, independent of their volume. The vascularity of the fibroid and capsule was related. VI was not related to the volume of the fibroid. CONCLUSIONS VI assessed using 3D PDUS is a reproducible parameter in the assessment of fibroid vascularization with discriminating abilities. Additional studies are needed to further evaluate its validity and clinical relevance.
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Affiliation(s)
- Lotte L Nieuwenhuis
- Department of Obstetrics and Gynaecology, VU Medical Center, Amsterdam, The Netherlands
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Casikar I, Mongelli M, Reid S, Condous G. Estimation of uterine volume: A comparison between Viewpoint and 3D ultrasound estimation in women undergoing laparoscopic hysterectomy. Australas J Ultrasound Med 2015; 18:27-32. [PMID: 28191238 PMCID: PMC5024953 DOI: 10.1002/j.2205-0140.2015.tb00020.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objectives: To assess the three‐dimensional (3D) tool, Virtual Organ Computed‐aided AnaLysis™ (VOCAL) in the calculation of pre‐operative uterine volume and to correlate the measurements with those obtained with Viewpoint, using uterine dry weight (UDW) as the gold standard. Methods: Prospective observational study of women consented for a laparoscopic hysterectomy (LH) at Nepean Hospital between October 2008 and November 2011. All women underwent detailed transvaginal scan (TVS) at the pre‐operative assessment. Two‐dimensional (D) images of the uterus were obtained both in the mid‐sagittal and transverse planes. 3D volumetric acquisitions were also obtained for each uterus in the mid‐sagittal plane. 2D measurements of the uterus in millimetres (Anterio‐Posterior, longitudinal and transverse) were recorded in Viewpoint software package (GE Healthcare ViewPoint, Germany); which then generated an estimated uterine volume (ml) using the ellipsoid formula. The 3D uterine volumetric datasets were reviewed using SonoView Pro and uterine volumes were estimated with off‐line processing using VOCAL™. The gold standard for comparison was UDW in grams (g), measured by the histopathologist at the time of analysis of the LH specimens. The relationship between the estimated uterine volumes and actual UDW was evaluated using correlation analysis. P‐values were calculated to ascertain the significance of these findings; P values &< 0.05 represented statistical significance. Results: 76 women underwent LH during the study period. Complete data were available in 96% (74/76) of cases. The mean age of the women was 43.7 years and 92% were multiparous. The mean Viewpoint uterine volume was 283 ml, the mean VOCAL™ uterine volume was 249 ml and the mean UDW was 295 g. There was a significant correlation between UDW and estimated uterine volumes both for Viewpoint (R = 0.83, P < 0.001) and VOCAL™ (R = 0.97, P < 0.001), respectively. Viewpoint systematically overestimated weight by 43.1 g, whereas VOCAL™ underestimated by an average of 42.4 g, and this difference was statistically significant (P < 0.001). In terms of absolute values, the mean prediction error for VOCAL™ was −18.0 g and for Viewpoint it was 27.6 g (P &< 0.0001). Conclusion: VOCAL™ was found to be significantly more accurate than Viewpoint in the estimation of uterine volumes, and it was better correlated with UDW.
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Affiliation(s)
- Ishwari Casikar
- Acute Gynaecology Early Pregnancy and Advanced Endosurgery UnitSydney Medical SchoolNepean; University of SydneyNepean HospitalPenrithNew South WalesAustralia
| | - Max Mongelli
- Acute Gynaecology Early Pregnancy and Advanced Endosurgery UnitSydney Medical SchoolNepean; University of SydneyNepean HospitalPenrithNew South WalesAustralia
| | - Shannon Reid
- Acute Gynaecology Early Pregnancy and Advanced Endosurgery UnitSydney Medical SchoolNepean; University of SydneyNepean HospitalPenrithNew South WalesAustralia
| | - George Condous
- Acute Gynaecology Early Pregnancy and Advanced Endosurgery UnitSydney Medical SchoolNepean; University of SydneyNepean HospitalPenrithNew South WalesAustralia
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Leone Roberti Maggiore U, Scala C, Venturini P, Remorgida V, Ferrero S. Endometriotic ovarian cysts do not negatively affect the rate of spontaneous ovulation. Hum Reprod 2014; 30:299-307. [DOI: 10.1093/humrep/deu308] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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[Placental 3D Doppler angiography: current and upcoming applications]. ACTA ACUST UNITED AC 2014; 44:107-18. [PMID: 25307617 DOI: 10.1016/j.jgyn.2014.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/03/2014] [Accepted: 09/10/2014] [Indexed: 11/20/2022]
Abstract
The placental dysfunction, which seems to be caused by a defect of trophoblastic invasion and impaired uterine vascular remodeling since the first trimester, is responsible in a non-exclusive way for the chronic placental hypoxia, resulting secondarily in the intra-uterine growth restriction (IUGR) and/or pre-eclampsia (PE). The quality of utero-placental vasculature is essential for a proper fetal development and a successful progress of pregnancy. However, the in vivo assessment of placental vascularization with non-invasive methods is complicated by the small size of placental terminal vessel and its complex architecture. Moreover, imaging with contrast agent is not recommended to pregnant women. Until recently, the fetal and maternal vascularization could only be evaluated through pulse Doppler of uterine arteries during pregnancy, which has little clinical value for utero-placental vascularization defects assessment. Recently, a non-invasive study, without use of contrast agent for vasculature evaluation of an organ of interest has become possible by the development of 3D Doppler angiography technique. The objective of this review was to make an inventory of its current and future applications for utero-placental vasculature quantification. The main findings of the literature on the assessment of utero-placental vascularization in physiological situation and major placental vascular dysfunction pathologies such as PE and IUGR were widely discussed.
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Leone Roberti Maggiore U, Scala C, Venturini PL, Ferrero S. Preoperative treatment with letrozole in patients undergoing laparoscopic myomectomy of large uterine myomas: a prospective non-randomized study. Eur J Obstet Gynecol Reprod Biol 2014; 181:157-62. [DOI: 10.1016/j.ejogrb.2014.07.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 07/23/2014] [Accepted: 07/29/2014] [Indexed: 10/24/2022]
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Rolo LC, Santana EFM, da Silva PH, Costa FDS, Nardozza LMM, Tonni G, Moron AF, Araujo Júnior E. Fetal cardiac interventricular septum: volume assessment by 3D/4D ultrasound using spatio-temporal image correlation (STIC) and virtual organ computer-aided analysis (VOCAL). J Matern Fetal Neonatal Med 2014; 28:1388-93. [PMID: 25134922 DOI: 10.3109/14767058.2014.955005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine reference values for fetal interventricular septum (IVS) volume by 3D/4D ultrasound using spatio-temporal image correlation (STIC) and virtual organ computer-aided analysis (VOCAL). METHODS A prospective cross-sectional study was conducted on 200 consecutive normal low-risk pregnant women at a gestational age ranging from 18w0d to 33w6d. The volume data sets of the fetal heart were acquired by applying STIC to a four-chamber plane. IVS volume was calculated offline using VOCAL with rotation of 30° (six planes). To assess the correlation of fetal IVS volume as a function of gestational age (GA), Pearson's correlation coefficient (r) and polynomial regression models with adjustments through the coefficient of determination (R(2)) were calculated. The intra-class coefficient (ICC) was used to evaluate intra- and inter-observer reproducibility. RESULTS A good correlation between GA and fetal IVS volume (r = 0.827) was observed. The mean fetal IVS volume ranged from 0.13 ± 0.03 cm(3) (0.08-0.18 cm(3)) at 18wd0 of gestation to 1.33 ± 0.37 cm(3) (0.41-1.98 cm(3)) at 33w6d. The best correlation between fetal IVS volume and GA was exponential: fetal IVS volume = 0.11e(0.139×GA) (R(2 )= 0.785). A good intra- and inter-observer reliability were observed, with ICC = 0.999 and 0.991, respectively. CONCLUSIONS Reference values for fetal IVS volume using STIC and VOCAL by 3D/4D ultrasound between 18w0d and 33w6d of gestation were determined and showed to be reliable and concordant.
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Affiliation(s)
- Liliam Cristine Rolo
- a Fetal Cardiology Unit, Department of Obstetrics , Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP) , São Paulo , SP , Brazil
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You JH, Lv GR, Liu XL, He SZ. Reference ranges of fetal spleen biometric parameters and volume assessed by three-dimensional ultrasound and their applicability in spleen malformations. Prenat Diagn 2014; 34:1189-97. [PMID: 25042792 DOI: 10.1002/pd.4451] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 06/06/2014] [Accepted: 06/27/2014] [Indexed: 11/11/2022]
Abstract
AIM The aims of this article are to establish three-dimensional ultrasonographic nomograms of normal fetal spleen size and to evaluate the clinical application value. METHODS An observational, cross-sectional study was performed on 455 women with a normal singleton pregnancy between 18 and 38 weeks' gestational age (GA). Fetal spleen volume was measured using three-dimensional ultrasound equipped with virtual organ computer-aided analysis, and biometric parameters were assessed in multiplanar mode to create reference ranges to GA. Thirty cases were randomly selected to conduct reliability analyses via intraobserver and interobserver ultrasonographic measurement. Moreover, 50 cases of suspected splenic malformations were evaluated by the newly established nomograms and followed up subsequently. RESULTS Using regression formulas, we found that fetal spleen size increased with GA. We observed strong reliability in intraobserver and interobserver volume measurements with intraclass correlation coefficients of 0.994 and 0.962. Bland-Altman analyses showed narrow limits of agreement [intraobserver: (-3.2 to 3.5)%; interobserver: (-3.2 to 4.3)%]. Of the 50 cases with suspected splenic malformations, six cases of splenomegaly and one case of splenic cyst were diagnosed. CONCLUSION Three-dimensional ultrasound nomograms of normal fetal spleen size across a range of GA have a strong diagnostic value. Volume measurements with good reliability were optimal in clinical practice.
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Affiliation(s)
- Jian-Hong You
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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Strizek B, Cos Sanchez T, Khalifé J, Jani J, Cannie M. Impact of operator experience on the variability of fetal lung volume estimation by 3D-ultrasound (VOCAL) and magnetic resonance imaging in fetuses with congenital diaphragmatic hernia. J Matern Fetal Neonatal Med 2014; 28:858-64. [DOI: 10.3109/14767058.2014.935760] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Papastefanou I, Kappou D, Souka AP, Pilalis A, Chrelias C, Siristatidis C, Kassanos D. Reproducibility study of fetal 3-D volumetry in the first trimester: effect of fetal size and rotational angle of VOCAL software. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:877-883. [PMID: 24412167 DOI: 10.1016/j.ultrasmedbio.2013.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 11/06/2013] [Accepted: 11/11/2013] [Indexed: 06/03/2023]
Abstract
Intra- and inter-observer reproducibility of fetal volume measurement by 3-D ultrasound scan (using VOCAL [Virtual Organ Computer-Aided Analysis] software) in 27 fetuses at 7 to 13 wk was studied. For intra-observer variability, the mean difference (MD) and 95% limits of agreement (95% LOA) at 12°, 18° and 30° were MD(12) = 0.097, 95% LOA(12) = -0.87 to +1.06; MD(18) = 0.07, 95% LOA(18) = -1.31 to +1.45; and MD(30) = -0.07, 95% LOA(30) = -1.55 to +1.41. The standard deviation of the differences (SD(DIF)) increased with crown-rump length at 12° (p = 0.0016), 18° (p = 0.0011) and 30° (p = 0.02). For inter-observer variability, MD(12) = 0.15, 95% LOA(12) = -1.65 to +1.95; MD(18) = 0.042, 95% LOA(18) = -1.79 to +1.87; and MD(30) = 0.19, 95% LOA(30) = -1.24 to +1.62. SDDIF increased with crown-rump length at 18° (p = 0.0084) and 30° (p = 0.0073). The accuracy of fetal volume measurement was not influenced by rotational angle or fetal size. Precision deteriorated for wider rotational angles and larger fetuses.
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Affiliation(s)
- Ioannis Papastefanou
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece.
| | - Dimitra Kappou
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece
| | - Athena P Souka
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece
| | - Athanasios Pilalis
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece
| | - Charalambos Chrelias
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece
| | - Charalambos Siristatidis
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece
| | - Dimitrios Kassanos
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece
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Abstract
Recent ultrasonographic methods applied in the evaluation of fetal thoracic structures and anomalies are presented. Fetal lung volumetric assessment by 3D ultrasonography, analysis of the thoracic wall by 3D-rendered image and 3D skeletal-mode imaging, intrathoracic vessel evaluation by 3D power Doppler ultrasonography, analysis of heart anatomy and abnormalities by 4D spatiotemporal image correlation, identification of normal and abnormal intrathoracic almost isoechogenic structures by volume contrast imaging and evaluation of the heart and great vessels by 3 and 4D inverse mode will be reviewed.
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Affiliation(s)
- Rodrigo Ruano
- Universidade de São Paulo-Brazil, R. Valentim Magalhaes 100 ap. 52, São Paulo, SP, 03184-090, Brazil.
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Reus AD, El-Harbachi H, Rousian M, Willemsen SP, Steegers-Theunissen RPM, Steegers EAP, Exalto N. Early first-trimester trophoblast volume in pregnancies that result in live birth or miscarriage. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2013; 42:577-584. [PMID: 23996572 DOI: 10.1002/uog.13197] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 07/12/2013] [Accepted: 08/12/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To assess the validity of trophoblast volume measurements on three-dimensional ultrasound (3D-US) with Virtual Organ Computer-aided AnaLysis (VOCAL(TM) ), to create reference values between 6 and 12 weeks of gestation and to compare trophoblast volume between pregnancies ending in miscarriage and those resulting in live birth. METHODS In a prospective periconceptional cohort, we performed weekly 3D-US in 112 singleton pregnancies resulting in a non-malformed live birth and in 56 ending in miscarriage. Scans were performed between 6 and 12 weeks. Trophoblast volumes were calculated by subtracting the gestational sac volume from the volume of the total pregnancy. The interobserver and intraobserver agreement of measurements were determined to assess validity. Reference values were created for trophoblast volume in relation to crown-rump length and gestational age. RESULTS A total of 722 3D-US examinations were available for offline VOCAL measurements, but measurements could be performed in only 53% of these due to non-targeted scanning and incomplete framing. Interobserver and intraobserver agreement for trophoblast volume measurements were excellent, with intraclass correlation coefficients > 0.97. Trophoblast volumes of pregnancies ending in miscarriage were significantly smaller (P < 0.01) than were those of pregnancies that resulted in live birth. Trophoblast growth in pregnancies ending in miscarriage was also reduced compared with that in pregnancies that resulted in live birth. CONCLUSION VOCAL is a valid technique for measuring trophoblast volume during the early first trimester of pregnancy. Pregnancies ending in miscarriage have smaller trophoblast volumes as well as reduced trophoblast growth compared with those that result in live birth.
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Affiliation(s)
- A D Reus
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Araujo Júnior E, Passos AP, Bruns RF, Nardozza LMM, Moron AF. Reference range of fetal cisterna magna volume by three-dimensional ultrasonography using the VOCAL method. J Matern Fetal Neonatal Med 2013; 27:1023-8. [DOI: 10.3109/14767058.2013.847419] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Barra DA, Lima JC, Mauad Filho F, Araujo Júnior E, Martins WP. Measuring fetal volume during late first trimester by three-dimensional ultrasonography using virtual organ computer-aided analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:1552-1559. [PMID: 23791355 DOI: 10.1016/j.ultrasmedbio.2013.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 02/02/2013] [Accepted: 02/07/2013] [Indexed: 06/02/2023]
Abstract
Our aim was to determine whether rotating the fetus over its largest axis and reducing the rotational step angle can improve reliability/agreement of fetal volume measurements obtained with three-dimensional ultrasonography (3-DUS). Two observers acquired three 3-DUS data sets for a fetus with a crown-rump length between 45 and 84 mm. These observers determined the fetal volume using virtual organ computer-aided analysis (VOCAL), by three different methods, with a rotational step angle of 30°: (1) minimal manipulation of the 3-DUS data set, fetus rotated over any axis; (2) manipulation of the 3-DUS data set until the fetus could be seen in a standardized manner, fetus rotated over its anteroposterior axis; (3) same 3-DUS data set manipulation, fetus rotated over its longitudinal axis. Intra- and inter-observer reliability/agreement was determined with intra-class correlation coefficients and limits of agreement. In addition, we tested the method that provided the best reliability/agreement results using 15° and 9° of rotational step angles. The time taken to manipulate 3-DUS and determine fetal volume was recorded. The best intra- and inter-observer reliability/agreement results were observed when the fetus was rotated over its longitudinal axis. Reducing rotational step angle to 15° or 9° did not further improve reliability/agreement. The observer took approximately 1 min to determine fetal volume using this method. Our findings indicate that fetal volume should be determined by rotating the fetus over its longitudinal axis, at a rotational step angle of 30°, which is relatively fast and allows analysis of fetal volume with good reliability and agreement.
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Affiliation(s)
- Daniela A Barra
- Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo (DGO-FMRP-USP), Ribeirao Preto, Brazil
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Kehl S, Becker L, Eckert S, Weiss C, Schaible T, Neff KW, Siemer J, Sütterlin M. Prediction of mortality and the need for neonatal extracorporeal membrane oxygenation therapy by 3-dimensional sonography and magnetic resonance imaging in fetuses with congenital diaphragmatic hernias. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2013; 32:981-988. [PMID: 23716519 DOI: 10.7863/ultra.32.6.981] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To compare different rotation angles for assessment of fetal lung volume by 3-dimensional (3D) sonography with magnetic resonance imaging (MRI) regarding prediction of mortality and the need for neonatal extracorporeal membrane oxygenation (ECMO) therapy in fetuses with congenital diaphragmatic hernias. METHODS One hundred patients with fetal congenital diaphragmatic hernias between 22 and 39 weeks' gestation were examined by 3D sonography and MRI. Sonographic contralateral fetal lung volumes were assessed by the rotational technique (virtual organ computer-aided analysis) at 3 different rotation angles: 6°, 15°, and 30°. The MRI fetal lung volumes were calculated based on multiplanar T2-weighted MRI. To eliminate the influence of gestational age, the observed to expected contralateral fetal lung volume on sonography and the observed to expected fetal lung volume on MRI were calculated. Receiver operating characteristic (ROC) curves were calculated for the statistical prediction of survival and need for ECMO therapy by the observed to expected contralateral fetal lung volume (sonography) and observed to expected fetal lung volume (MRI). RESULTS One hundred cases were assessed for survival and 89 for ECMO necessity (11 neonates were not eligible for ECMO). For prediction of postpartum survival and ECMO necessity, the areas under the ROC curves (AUCs) showed very similar results for MRI and 3D sonography: observed to expected fetal lung volume by MRI, 0.819 (95% confidence interval, 0.730-0.909) and 0.835 (0.748-0.922), respectively; 6° sonography, 0.765 (0.647-0.883) and 0.820 (0.734-0.905); 15° sonography, 0.784 (0.672-0.896) and 0.811 (0.719-0.903); and 30° sonography, 0.732 (0.609-0.855) and 0.772 (0.671-0.872). Comparisons between the AUCs revealed no statistical differences. CONCLUSIONS We have shown the good prognostic value of 3D sonography in fetuses with congenital diaphragmatic hernias compared with MRI, particularly when using small rotation angles. Therefore, it can be an appropriate diagnostic tool when counseling patients for congenital diaphragmatic hernias.
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Affiliation(s)
- Sven Kehl
- Department of Obstetrics and Gynecology, Mannheim University Medical Center, Mannheim, Germany.
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Bojikian KD, de Moura CR, Tavares IM, Leite MT, Moron AF. Fetal ocular measurements by three-dimensional ultrasound. J AAPOS 2013; 17:276-81. [PMID: 23791409 DOI: 10.1016/j.jaapos.2013.02.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 01/11/2013] [Accepted: 02/10/2013] [Indexed: 11/16/2022]
Abstract
PURPOSE To establish a reference range for normal fetal eye volume (FEV) by three-dimensional ultrasound using Virtual Organ Computer-aided AnaLysis (VOCAL) method and compare the reproducibility between the two trace modes (manual and sphere). METHODS This prospective, longitudinal observational study was performed at a single center and involved 71 eyes of 37 fetuses between 17 and 40 weeks of gestational age. Only pregnancies without fetal growth restriction, diabetes mellitus, hypertension, or major fetal malformation were included. Fetuses' eye measurements were obtained by a single observer during routine ultrasonographic examination. RESULTS Mean FEV manual mode ranged from 309.5 ± 80.1 mm(3) at 17-18 weeks to 2552.1 ± 384.9 mm(3) at 39-40 weeks. Mean FEV sphere mode ranged from 394.8 ± 71.8 mm(3) at 17-18 weeks to 2682.1 ± 343.4 mm(3) at 39-40 weeks. Correlations ranged from R² = 0.85 (transversal diameter and gestational age) to R² = 0.91 (FEV sphere mode and gestational age). All correlations were statistically significant (P < 0.001). Although highly correlated (R² = 0.97, P < 0.001), there was a fixed bias between manual and sphere measurements. The agreement between these measurements showed no proportional bias (P = 0.89). CONCLUSIONS The present study establishes reference values for FEV using the VOCAL method manual mode. These normal growth parameters can be used in routine ultrasound assessment of the fetal eye, especially in families at risk of genetic diseases that affect ocular growth, such as congenital glaucoma.
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Affiliation(s)
- Karine Duarte Bojikian
- Department of Ophthalmology, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil.
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Anquez J, Angelini ED, Grange G, Bloch I. Automatic Segmentation of Antenatal 3-D Ultrasound Images. IEEE Trans Biomed Eng 2013; 60:1388-400. [DOI: 10.1109/tbme.2012.2237400] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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