超声和MRI测量胎儿侧脑室扩张的一致性评估

Consistency of the measurement data of fetal ventriculomegaly on ultrasound and MRI

目的:分析胎儿侧脑室扩张的产前超声和胎儿磁共振(MRI)的影像测量资料,评估对比产前超声、胎儿MRI两种检查的测量结果是否存在差异。方法:选取2018年6月—2020年9月于广州医科大学附属广州市妇女儿童医疗中心进行中晚孕期产前检查并发现胎儿侧脑室扩张的孕妇78例,孕妇均进行超声及MRI两项检查,两种检查相隔在两周内。超声是在胎儿颅脑横切面上测量胎儿侧脑室的,并分别测量扩张的左侧或右侧侧脑室的后角,胎儿MRI是在胎儿颅脑冠状切面上进行的,测量脉络丛(三角区)水平侧脑室内外侧壁的间距。分析对比超声及MRI检查测量左侧侧脑室和右侧侧脑室的结果一致性。结果:测量扩张的侧脑室122例,其中左侧72例,右侧50例。采用Kappa系数评估超声和MRI测量侧脑室扩张的一致性时,左侧侧脑室Kappa值为0.70,右侧侧脑室为0.72。根据轻度、中度、重度的超声分级方法评估超声和MRI测量侧脑室扩张的一致性时,104/122(85.2%)的超声和MRI测量结果一致,18/122(14.8%)的测量结果不一致。Bland-Altman分析散点图显示大部分点位于95%的一致性界限内,偏倚(MRI测量所得值-超声测量所得值)和一致性限值为:左侧0.79(-2.38~3.95);右侧0.53(-1.98~3.04)。当对两配对测量值之间进行Pearson相关性检验时,超声和MRI测量左侧侧脑室和右侧侧脑室的测量值呈正相关性,左侧侧脑室r=0.76,右侧侧脑室r=0.78(P=0.000<0.05)。结论:研究表明,在胎儿颅脑超声和MRI检查常规使用观察测量胎儿侧脑室的断层切面上,胎儿侧脑室扩张的超声和MRI测量结果具有较好的一致性。

Objective To analyze the measurement data of fetus diagnosed with ventriculomegaly on antenatal ultrasound and magnetic resonance image(MRI),and evaluate whether there is difference in the measurement data of trigone size between two methods.Methods Select data From June 2018 to September 2020,at Guangzhou Medical University Affiliated Guangzhou Women and Children Medical Center,78 cases of women with fetal ventriculomegaly were included.The pregnant women were examined both by ultrasound and MRI within two weeks.Measurement of fetal Ventriculomegaly by Ultrasound is performed on the transverse section of the fetal brain,and the posterior angle of the left or right ventricle is measured respectively.MRI is performed on the coronal section of the fetal brain to measure the size of the ventriculomegaly,the distance is between the inner and outer walls of the ventricle at the level of the choroid plexus(triangular area).Analyze and compare the consistency the measurement data of the left and the right fetalventriculomegaly between ultrasound and MRI.Result There were 72 cases in the left lateral ventricle and 50 cases in the right lateral ventricle,when the kappa coefficient was used to evaluate the consistency of ultrasound and MRI measurement of ventriculomegaly,the Kappa value was 0.70 for the left and 0.72 for the right.When comparing the consistency of ultrasound and MRI by taking the size of the largest trigone and classified it as mild,moderate,and severe,the results showed that 104/122(85.2%)of were consistent,and 18/122(14.8%)are inconsistent.Bland-Altman analysis of the scatter plot shows that most of the points are within the 95%agreement limit,and the bias(value obtained by MRI minus value obtained by ultrasound)and the limit of agreement are:left 0.79(-2.38~3.95);right 0.53(-1.98~3.04).When the Pearson correlation test is performed between the two paired measurement values,there is a positive correlation between the left and right ventriculomegaly measured on ultrasound and on MRI,the value of left is r=0.76,and the right is r=0.78(P=0.000﹤0.05).Conclusion This study shows that in the routine tomographic section of antenatal ultrasound and MRI by taking the size of the largest trigone there was a close agreement between them.