比较超声和MRI评估正常胎儿胸廓发育

Comparison of ultrasonography and MRI in evaluating normal fetal thoracic development

目的比较超声和MRI评估正常胎儿胸廓发育的可重复性和一致性。方法选取30胎正常胎儿,分别以超声和MRI测量胎儿胸廓横径、前后径、面积、胸围、胸廓体积和肺体积,采用组内相关系数(ICC)及Bland-Altman图分析同一医师及不同医师间测量结果的可重复性和一致性,以Pearson相关分析观察超声测量胎儿肺体积、胸廓体积与MRI测量值的相关性。结果同一医师及不同医师以超声测量胎儿胸廓二维指标的可重复性和一致性均高于MRI,而以MRI测量胎儿胸廓体积和肺体积的可重复性和一致性均高于超声;同一医师以超声测量胎儿胸廓横径的可重复性最高[ICC=0.996 4,95%CI(0.992 5,0.998 3)],且一致性最高[界限宽度-0.004 7±0.057 3,95%CI(-0.026 1,0.016 7)]。超声与MRI测量胎儿肺体积和胸廓体积高度相关(r=0.915、0.957,P均<0.001)。结论超声和MR均可评估正常胎儿胸廓发育,胎儿胸廓发育的二维指标测量超声优于MRI;三维指标测量MRI优于超声,但两者相关性高。

Objective To compare the repeatability and consistency of ultrasound and MRI in evaluating normal fetal thoracic development. Methods Thirty normal fetuses were selected. The thoracic transverse diameter, anteroposterior diameter, area, circumference, volume and lung volume of fetuses were measured with ultrasonography and MRI. The repeatability and consistency of the measurement results of the same physician and different physicians were analyzed by using intraclass correlation coefficient(ICC) and Bland-Altman, and the correlation of ultrasound and MRI in measuring the lung and thoracic volume was analyzed with Pearson correlation analysis. Results The inter-/intra-physicians repeatability and consistency of fetal thorax of 2 D ultrasound measurement were higher than those of MRI, while the intra-/inter-operator repeatability and consistency of fetal thoracic volume and lung volume measured with MRI were higher than those with ultrasound. The inter-physicians reproducibility and consistency of ultrasound in measuring fetal thoracic transverse diameter were the highest(ICC=0.996 4, 95%CI [0.992 5, 0.998 3]), boundary width=-0.004 7±0.057 3, 95%CI [-0.026 1, 0.016 7]). The fetal lung volume and thoracic volume measured with ultrasound were correlated with MRI(r=0.915, 0.957, both P<0.001). Conclusion Ultrasonography and MRI are feasible in evaluating normal fetal thoracic development. Ultrasonography is superior to MRI in measuring 2 D indexes of fetal thoracic development, while MRI is superior to ultrasound in measuring 3 D indexes of fetal thoracic development, but the results have high correlation.