Volume NT^(TM)测量胎儿颈项透明层厚度的研究

Measurement of nuchal translucency with a new technque Volume NT^(TM): a pilot study

目的探讨Volume NTTM方法测量胎儿颈项透明层厚度(nuchal translucency,NT)的可行性。方法收集行NT超声检查的277例孕11~13+6周的单胎妊娠胎儿,头臀长45~84 mm。先由一位高年资医师用二维超声及Volume NTTM方法分别测量胎儿NT并且记录所需时间,比较两者测量值。再随机选取100例胎儿,由一位高年资医师和低年资医师分别使用两种方法测量胎儿NT 2次,分析其组内及组间差异。结果 277例胎儿中,Volume NTTM方法成功262例,二维方法成功254例。二维方法测得NT平均值(1.4±0.3)mm,Volume NTTM方法测得NT平均值(1.4±0.4)mm,差异无统计学意义(P=0.086>0.05)。二维方法获得标准正中矢状切面时间长于Volume NTTM[(122.8±85.9)vs(94.1±75.0)s,P=0.000<0.05]。随机抽取的100例胎儿中,两位不同年资的医师用两种方法都成功的共有86例。高年资医师使用Volume NTTM方法及二维方法,ICC分别为0.978、0.960,而低年资医师的ICC分别为0.780、0.285。两位不同年资医师用Volume NTTM方法测得的NT差异无统计学意义(F=1.34,P=0.25>0.05),用二维方法测得的NT差异有统计学意义(F=4.02,P=0.04<0.05)。结论 Volume NTTM方法作为一种超声新技术,测量NT是可行的。

Objective To evaluate the feasibility of nuchal translucency（ NT） measurement with Volume NTTM. Methods Two hundred and seventy seven singleton pregnancy women with a gestation of 11-13 weeks,undergoing ultrasonography examination were enrolled in the study. The crown-rump length（ CRL） of fetuses ranged from 45 mm to 84 mm. The NT values of fetuses were measured by one senior sonographer with 2D ultrasound and Volume NTTM,respectively. The inter-and intrameasurement variance was analyzed based on the NT values of 100 fetuses measured with 2D ultrasound and Volume NTTMby two sonographers. Results NT measurement was successfully performed in 262 cases with Volume NTTM,and in 254 cases with 2D ultrasound. There were no significant differences between NT values measured by 2D ultrasound and those by Volume NTTM[（ 1. 4 ± 0. 3） mm vs（ 1. 4 ± 0. 4） mm,P = 0. 086） ],whereas there were significant difference in length of measurement time between 2D ultrasound and Volume NTTM[（ 122. 8 ± 85. 9） vs（ 94. 1 ±75. 0） s,P = 0. 000） ]. In intra-and inter-measurement analysis 2D ultrasound and Volume NTTMwere successfully performed by two sonographers with different experiences in 86 out of 100 cases of fetuses. The intraclass correlation coefficient（ ICC） of the senior sonographer was 0. 978（ P = 0. 000）for Volume NTTMand 0. 960（ P = 0. 000） for 2D ultrasound; while those by the junior sonographer were0. 780（ P = 0. 00） and 0. 28（ P = 0. 06）; Between—sonographer measurement was associated with F =1. 34（ P = 0. 25） for Volume NTTMand F = 4. 02（ P = 0. 04） for 2D ultrasound. Conclusion It is feasible to measure NT by Volume NTTM,and its clinical value should be confirmed in further study.