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Matthew J, Malamateniou C, Knight CL, Baruteau KP, Fletcher T, Davidson A, McCabe L, Pasupathy D, Rutherford M. A comparison of ultrasound with magnetic resonance imaging in the assessment of fetal biometry and weight in the second trimester of pregnancy: An observer agreement and variability study. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2018; 26:229-244. [PMID: 30479638 DOI: 10.1177/1742271x17753738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 12/21/2017] [Indexed: 11/16/2022]
Abstract
Objective To compare the intra and interobserver variability of ultrasound and magnetic resonance imaging in the assessment of common fetal biometry and estimated fetal weight in the second trimester. Methods Retrospective measurements on preselected image planes were performed independently by two pairs of observers for contemporaneous ultrasound and magnetic resonance imaging studies of the same fetus. Four common fetal measurements (biparietal diameter, head circumference, abdominal circumference and femur length) and an estimated fetal weight were analysed for 44 'low risk' cases. Comparisons included, intra-class correlation coefficients, systematic error in the mean differences and the random error. Results The ultrasound inter- and intraobserver agreements for ultrasound were good, except intraobserver abdominal circumference (intra-class correlation coefficient = 0.880, poor), significant increases in error was seen with larger abdominal circumference sizes. Magnetic resonance imaging produced good/excellent intraobserver agreement with higher intra-class correlation coefficients than ultrasound. Good interobserver agreement was found for both modalities except for the biparietal diameter (magnetic resonance imaging intra-class correlation coefficient = 0.942, moderate). Systematic errors between modalities were seen for the biparietal diameter, femur length and estimated fetal weight (mean percentage error = +2.5%, -5.4% and -8.7%, respectively, p < 0.05). Random error was above 5% for ultrasound intraobserver abdominal circumference, femur length and estimated fetal weight and magnetic resonance imaging interobserver biparietal diameter, abdominal circumference, femur length and estimated fetal weight (magnetic resonance imaging estimated fetal weight error >10%). Conclusion Ultrasound remains the modality of choice when estimating fetal weight, however with increasing application of fetal magnetic resonance imaging a method of assessing fetal weight is desirable. Both methods are subject to random error and operator dependence. Assessment of calliper placement variations may be an objective method detecting larger than expected errors in fetal measurements.
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Affiliation(s)
- Jacqueline Matthew
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK.,NIHR Biomedical Research Centre, Guy's and St Thomas' NHS Hospital Foundation Trust, London, UK
| | - Christina Malamateniou
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK.,Department of Family Care and Mental Health, Faculty of Education and Health, University of Greenwich, London, UK
| | - Caroline L Knight
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK.,Department of Women and Children's Health, King's College London, King's Health Partners, St. Thomas' Hospital, London, UK
| | - Kelly P Baruteau
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK.,Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Tara Fletcher
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK.,Radiology Department, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Alice Davidson
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
| | - Laura McCabe
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
| | - Dharmintra Pasupathy
- Department of Family Care and Mental Health, Faculty of Education and Health, University of Greenwich, London, UK
| | - Mary Rutherford
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
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Abstract
This study aimed to evaluate the diagnostic accuracy of fetal magnetic resonance imaging (MRI) for persistent left superior vena cava (LSVC). Prenatal echocardiography (echo) and/or ultrasound (US) and MRI data for 49 fetuses with persistent LSVC, confirmed via postnatal diagnoses between January 2010 and October 2015, were retrospectively reviewed. All prenatal MRI was performed at 1.5 T. Imaging sequences included steady-state free-precession (SSFP), single-shot turbo spin echo (SSTSE), and other sequences. All 49 cases of fetal persistent LSVC were correctly diagnosed via MRI, but only 34 cases (69.4%) were correctly diagnosed via an initial US and/or echo before MRI. Of the 15 cases that were not correctly diagnosed via US and/or echo, 8 had congenital heart diseases (CHDs) and 7 were without CHDs; however, they were associated with extracardiac abnormalities or maternal obesity. Thirty-five cases were associated with other cardiovascular abnormalities; 8, with extracardiac abnormalities; and 6, with no associated condition. In 44 (89.8%) cases, the innominate veins were absent; the remaining cases had innominate veins. In 14.3% of patients (7 cases), the persistent LSVC drained directly into the atrium. Fetal MRI can detect persistent LSVC and play an adjunctive role along with US in the evaluation of persistent LSVC.
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