SonoNT半自动测量软件测量胎儿颈项透明层的初步研究

Semi-automated software （SonoNTTM） for measurement of nuchal translucency in fetus： a pilot study

目的评价SonoNT半自动测量与手动测量两种方法测量胎儿颈项透明层（NT）的一致性及不同超声工作者的组内、组间差异。方法2011年2月至4月期间在本院行早孕期超声筛查的正常胎儿58例为研究对象，经腹超声显示每例胎儿的NT测量标准切面后储存图像，由一位高年资医生分别使用Sono NT半自动测量与手动测量所有胎儿的NT各1次，分析两种测量方法的一致性。按随机数字表法抽取30例胎儿超声图像，由不同年资的两位医生分别使用两种方法测量胎儿NT各2次，分析其组内和组间差异。结果高年资医生手动测量58例胎儿NT均值为（1．40_＋0．39）mm，SonoNT^lJ量NT均值为（1．44=t：0．42）mm，两种测量方法的组间相关系数（Icc）为0．928（P=0．000），两种测量方法测量值的差值为（0．042＋0．160）mm，95％一致性范围为一0．278～0．362mm。随机抽取30例胎儿超声图像，高年资医生的使用SonoNT测量、手动测量NT各2次，其ICC分别为0．997（P=0．000）、0．965（P=0．000）；而低年资医生的ICC分别为0．993（P=0．000）、0．889（P=0．000）。两位医生使用SonoNT软件测量NT的ICC为0．963（P=0．000），手动测量的ICC为0．970（P=0．000）。结论SonoNT的NT测量值较手动测量值偏大，但两者的相关性良好。SonoNT可有效改善检查者，尤其是低年资医生的NT测量值的组间和组内差异。

Objective To compare the concordance, intersonographer and intrasonographer variance of measurement of fetal nuehal translucency （NT） via semi-automated system （SonoNTTM） and manual operation. Methods The profiles of 58 healthy fetuses during early pregnancy for uhrasonographie examination in our hospital between February 2011 and April 2011 were analyzed, and the images of abdominal ultrasonographic measurement of NT at standard section were saved. Assessment of NT was performed by an experienced sonographer using semi-automated system and manual operation respectively, thus allowing for measurement of between-test consistency. A total of 30 fetuses ultrasound images was further randomly selected via random-number table, followed by check twice using semi-automated system and manual operation by two sonographers with different experience for subsequent analysis of intersonographer and intrasonographer variance. Results The experienced sonographer yielded the mean NT of （1.40＋0.39） mm and （1.44＋0.42） mm among 58 fetuses by manual operation and SonoNTTM （P=0.045） respectively. This gave an interclass correlation coefficient （ICC） of 0.928 （P=0.000）, mean between-test variability of （0.042：t：0.160） mm and 95% consistency range of （-0.278 to 0.362） mm. Of the profiles in 30 fetuses being analyzed, ICC of the experienced sonographer was 0.997（P=0.000） fi）r ~moN3TM and 0.965 （P=0.000） for manual operation, while these figures were 0.993 （P=0.000） and 0.889 （P=0.000） for the inexperienced sonographer. Between-sonographer measurement was associated with an ICC of 0.963 （P=0.000） fur SonoNTTM and 0.970 （P=0.000） for manual operation. Conclusions Result of NT measured by SonoNTTM is higher than that of manual operation while both approaches are featured of preferable ton＇elation. SonoNTTM reduces intersonographer and intrasonugrapher variance particularly among inexperienced sonographers.