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Surgical Selection of T1 Stage Renal Tumor Resection Based on Imaging MAP Score under Smart Medical Care. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:1947504. [PMID: 35634081 PMCID: PMC9132642 DOI: 10.1155/2022/1947504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/18/2022] [Accepted: 04/29/2022] [Indexed: 11/17/2022]
Abstract
Smart medical uses the medical information platform and the current technological means to enable the process of sharing information between medical staff and medical equipment. The combination of current technology and the medical field has become the norm. In the future, more artificial intelligence technologies will be integrated into the medical field to promote the development of medical care. At present, the information on the Internet is very large and complex, and general search engines often do not have knowledge in certain professional fields and can only perform shallow keyword searches. Therefore, it is difficult to meet people's medical diagnosis needs, and smart medical care can solve these needs. Medical imaging refers to the technology or process of obtaining internal tissue images of a certain part of the human body for medical research, including medical imaging systems and medical image processing. Medical image processing refers to the further processing of the obtained images, the purpose of which is either to restore the original image that was not clear enough or to highlight some characteristic information in the image. The purpose of this paper is to study the research on the selection of T1 stage renal tumor resection based on the imaging MAP score under smart medical care. It is hoped that through smart medicine and medical imaging technology, it can help renal tumor resection, reduce the sequelae of renal tumor resection, and promote the development of medical services. This paper proposes applying natural language processing technology to the medical field, creating an intelligent diagnosis assistance system, and using the existing medical record data to realize the corresponding medical assistance functions. It studies the class imbalance problem prevalent in medical datasets and provides better solutions through ensemble learning techniques to improve classifier performance when the number of positive and negative samples is unbalanced. The experimental results in this paper show that the creatinine of patients undergoing renal tumor resection combined with smart medicine and imaging technology is stable at 75 mol/L, while the creatinine is stable at 71 mol/L in other methods. It shows that the postoperative effect of smart medical treatment and imaging technology is better.
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Bardi F, Bergman JEH, Bouman K, Erwich JJ, Duin LK, Walle HEK, Bakker MK. Effect of prenatal screening on trends in perinatal mortality associated with congenital anomalies before and after the introduction of prenatal screening: A population-based study in the Northern Netherlands. Paediatr Perinat Epidemiol 2021; 35:654-663. [PMID: 34328233 PMCID: PMC8596841 DOI: 10.1111/ppe.12792] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/05/2021] [Accepted: 05/14/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Perinatal mortality in foetuses/children with congenital anomalies remains high. Prenatal diagnosis, essential for risk assessment and organisation of perinatal/postnatal care, offers parents the opportunity to consider the termination of pregnancy. In times of quick changes in prenatal screening programmes, it is relevant to evaluate the effect of prenatal screening on perinatal mortality rates. OBJECTIVES The objective of this study was to study trends in early foetal and perinatal mortality associated with congenital anomalies before/after the introduction of the Dutch prenatal screening programme. METHODS This population-based cohort study included 8535 foetuses/neonates with congenital anomalies born in the Northern Netherlands between 2001 and 2017. Total deaths were defined as sum of early foetal (before 24 weeks' gestation) and perinatal deaths (from 24 weeks' gestation till day 7 post-partum). Foetal deaths were categorised into spontaneous or elective termination of pregnancy for foetal anomalies (TOPFA). Trends in total mortality as well as early foetal and perinatal mortality were studied. Joinpoint regression was used to calculate the average annual percentage chance (AAPC) and identify linear trends in mortality within subperiods. RESULTS Total and perinatal mortality were 17% and 4%. Total mortality was higher in abnormal karyotype and central nervous system anomalies. We observed an increase in total mortality over time: 11.9% in 2001 versus 21.9% in 2017 (AAPC 2.6, 95% confidence interval [CI] 1.5, 3.7), caused by an increase in early foetal mortality from 5.5% to 19.2% (AAPC 8.7, 95% CI 4.7, 12.9) and a decrease in perinatal mortality from 6.4% to 2.7% (AAPC -5.6, 95% CI -10.0, -1.0). The increase in early foetal mortality reflects an increase in TOPFA from 3.6% to 16.9% (AAPC 8.3, 95% CI 4.2, 12.7), mostly occurring at 13-14 and 20-23 weeks' gestation. CONCLUSIONS The introduction of the prenatal screening programme led to a decrease in perinatal mortality among foetuses and neonates with congenital anomalies and a marked increase in early foetal mortality before 24 weeks' gestation due to higher rates of TOPFA.
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Affiliation(s)
- Francesca Bardi
- Department of Obstetrics and GynecologyUniversity Medical Centre GroningenGroningenThe Netherlands
| | - Jorieke E. H. Bergman
- Department of GeneticsEUROCAT Registration Northern NetherlandsUniversity Medical Centre GroningenGroningenThe Netherlands
| | - Katelijne Bouman
- Department of GeneticsEUROCAT Registration Northern NetherlandsUniversity Medical Centre GroningenGroningenThe Netherlands
| | - Jan Jaap Erwich
- Department of Obstetrics and GynecologyUniversity Medical Centre GroningenGroningenThe Netherlands
| | - Leonie K. Duin
- Department of Obstetrics and GynecologyUniversity Medical Centre GroningenGroningenThe Netherlands
| | - Hermien E. K. Walle
- Department of GeneticsEUROCAT Registration Northern NetherlandsUniversity Medical Centre GroningenGroningenThe Netherlands
| | - Marian K. Bakker
- Department of GeneticsEUROCAT Registration Northern NetherlandsUniversity Medical Centre GroningenGroningenThe Netherlands
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Skelton E, Matthew J, Li Y, Khanal B, Cerrolaza Martinez JJ, Toussaint N, Gupta C, Knight C, Kainz B, Hajnal JV, Rutherford M. Towards automated extraction of 2D standard fetal head planes from 3D ultrasound acquisitions: A clinical evaluation and quality assessment comparison. Radiography (Lond) 2021; 27:519-526. [PMID: 33272825 PMCID: PMC8052189 DOI: 10.1016/j.radi.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/05/2020] [Accepted: 11/09/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Clinical evaluation of deep learning (DL) tools is essential to compliment technical accuracy metrics. This study assessed the image quality of standard fetal head planes automatically-extracted from three-dimensional (3D) ultrasound fetal head volumes using a customised DL-algorithm. METHODS Two observers retrospectively reviewed standard fetal head planes against pre-defined image quality criteria. Forty-eight images (29 transventricular, 19 transcerebellar) were selected from 91 transabdominal fetal scans (mean gestational age = 26 completed weeks, range = 20+5-32+3 weeks). Each had two-dimensional (2D) manually-acquired (2D-MA), 3D operator-selected (3D-OS) and 3D-DL automatically-acquired (3D-DL) images. The proportion of adequate images from each plane and modality, and the number of inadequate images per plane was compared for each method. Inter and intra-observer agreement of overall image quality was calculated. RESULTS Sixty-seven percent of 3D-OS and 3D-DL transventricular planes were adequate quality. Forty-five percent of 3D-OS and 55% of 3D-DL transcerebellar planes were adequate. Seventy-one percent of 3D-OS and 86% of 3D-DL transventricular planes failed with poor visualisation of intra-cranial structures. Eighty-six percent of 3D-OS and 80% of 3D-DL transcerebellar planes failed due to inadequate visualisation of cerebellar hemispheres. Image quality was significantly different between 2D and 3D, however, no significant difference between 3D-modalities was demonstrated (p < 0.005). Inter-observer agreement of transventricular plane adequacy was moderate for both 3D-modalities, and weak for transcerebellar planes. CONCLUSION The 3D-DL algorithm can automatically extract standard fetal head planes from 3D-head volumes of comparable quality to operator-selected planes. Image quality in 3D is inferior to corresponding 2D planes, likely due to limitations with 3D-technology and acquisition technique. IMPLICATIONS FOR PRACTICE Automated image extraction of standard planes from US-volumes could facilitate use of 3DUS in clinical practice, however image quality is dependent on the volume acquisition technique.
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Affiliation(s)
- E Skelton
- Perinatal Imaging Department, King's College London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, UK.
| | - J Matthew
- Perinatal Imaging Department, King's College London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, UK
| | - Y Li
- Department of Computing, Imperial College London, UK
| | - B Khanal
- School of Biomedical Engineering and Imaging Sciences, King's College London, UK
| | | | - N Toussaint
- School of Biomedical Engineering and Imaging Sciences, King's College London, UK
| | - C Gupta
- Perinatal Imaging Department, King's College London, UK
| | - C Knight
- Perinatal Imaging Department, King's College London, UK; Guy's & St Thomas' NHS Foundation Trust, UK
| | - B Kainz
- School of Biomedical Engineering and Imaging Sciences, King's College London, UK; Department of Computing, Imperial College London, UK
| | - J V Hajnal
- Perinatal Imaging Department, King's College London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, UK
| | - M Rutherford
- Perinatal Imaging Department, King's College London, UK; Guy's & St Thomas' NHS Foundation Trust, UK
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Verfaille V, Haak MC, Pajkrt E, de Jonge A, Henrichs J, Franx A, Jellema P. Quality assessment of ultrasonic foetal biometry during the IUGR Risk Selection (IRIS) trial: A cross sectional study. Midwifery 2020; 91:102842. [PMID: 33011426 DOI: 10.1016/j.midw.2020.102842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/30/2020] [Accepted: 09/18/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Intrauterine growth restriction is a major risk factor for perinatal morbidity and mortality. Ultrasonic foetal biometry is an important tool to monitor foetal growth. Therefore, the quality of these biometry scans is vital to achieve good diagnostic accuracy. We assessed the quality of foetal biometry during a nationwide trial and explored its association with sonographer's characteristics. METHODS Four scans from every sonographer (n = 154), performed at 29 and 35 weeks gestational age were collected. Two assessors scored these scans according to a national audit system. A quality score ≥ 65% was considered 'adequate'. We compared the quality scores per scoring criterion (i.e. foetal head measurements, abdominal circumference and femur length with regard to magnification, correctness of the plane and calliper placement) and gestational age. We analysed the associations between characteristics of the sonographers and their scores. In a subsample of scans of 30 sonographers we determined the interrater agreement on the quality scores given by the two assessors independently. FINDINGS The mean score was 81.3%. Thirteen sonographers (8.4%) failed to achieve 'adequate quality'. Scores for femur length (83.8%) were significantly higher than those for head (77.9%) and abdominal circumference (78.6%) (both P < 0.05). Scores for correctness of the plane (73.4%) were lower than those for magnification (81.2%) and calliper placement (85.7%) (both P < 0.05). Gestational age did not affect the quality scores. Only the number of scans performed in the previous year was positively associated with the scores (β = 0.01; P < 0.05). The mean interrater difference in quality scoring was 11.1%, with 77.6% agreement on scans of 'adequate quality', but with no agreement on scans with 'insufficient quality'. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Most sonographers achieved an 'adequate quality' score. Highest quality scores were attained for femur length, lowest quality scores for the correct plane. The number of scans one performs is associated with the quality scores, yet the minimum number of scans to perform for guaranteed quality still needs to be determined. Further research is needed to develop a standardized method to assess and maintain good ultrasonic foetal biometry quality.
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Affiliation(s)
- Viki Verfaille
- Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; Dutch Professional Organisation of Sonographers, Edisonweg 8, 3442 AC Woerden, the Netherlands.
| | - Monique C Haak
- Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
| | - Eva Pajkrt
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centre, AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
| | - Ank de Jonge
- Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
| | - Jens Henrichs
- Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
| | - Arie Franx
- University Medical Centre Utrecht, Lundlaan 6, 3584 EA Utrecht, the Netherlands; Department of Obstetrics and gynaecology, Erasmus Medical University Centre, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
| | - Petra Jellema
- Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; Zorginstituut Nederland, Willem Dudokhof 1, 1112 ZA Diemen, the Netherlands.
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Dyer E, Chudleigh T. Peer review of third trimester abdominal circumference measurements. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2020; 29:83-91. [PMID: 33995554 DOI: 10.1177/1742271x20954226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 08/09/2020] [Indexed: 11/17/2022]
Abstract
Background Third trimester growth scans represent a significant proportion of the workload in obstetric ultrasound departments. The objective of these serial growth scans is to improve the antenatal detection of babies with fetal growth restriction. The aim of this paper is to describe a method of peer review for third trimester abdominal circumference measurements which is realistic within busy obstetric ultrasound departments in the UK. Method Twenty-two, third trimester, measured abdominal circumference images were randomly selected. Images were assessed subjectively by 12 sonographers using the image Criteria Achieved Score. For quantitative assessment, termed the Inter-operator Variability Score, three of the abdominal circumference (AC) images were blindly remeasured. Following this, a questionnaire was used to ascertain which image criteria sonographers considered most important and to reach an agreement on correct caliper placement. Results The least frequently met image criteria with the lowest Criteria Achieved Score related to an oblique abdominal circumference section. These included fetal kidney present (Criteria Achieved Score 24.6%), multiple oblique ribs (Criteria Achieved Score 39.4%) and oblique spine (Criteria Achieved Score 37.5%). Caliper placement was also identified as inconsistent. Discussion This study demonstrates that the perfect AC section is not always possible and sonographers use their professional judgement to determine whether an image is acceptable. Seventy-three percent of the images reviewed were of an acceptable standard. There can be inconsistencies in sonographer opinion regarding what is an acceptable third trimester abdominal circumference image. These differences need to be addressed to maximise the effectiveness of the third trimester ultrasound examination. Conclusion Peer review can be used to monitor scan quality and identify areas of inconsistency.
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Affiliation(s)
- Ellen Dyer
- Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Trish Chudleigh
- Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
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Pinto NM, Henry KA, Grobman WA, Ness A, Miller S, Ellestad S, Gotteiner N, Tacy T, Wei G, Minich LL, Kinney AY. Physician Barriers and Facilitators for Screening for Congenital Heart Disease With Routine Obstetric Ultrasound: A National United States Survey. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1143-1153. [PMID: 31875341 PMCID: PMC7357993 DOI: 10.1002/jum.15199] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/06/2019] [Accepted: 11/29/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Prenatal detection of congenital heart disease with obstetric screening remains at less than 50% in most population studies, far from what is thought to be achievable. We sought to identify barriers/facilitators for screening from the perspective of interpreting physicians and to understand how these barriers/facilitators may be associated with interpretation of screening images. METHODS Our mixed-methods studies included 4 focus groups in centers across the United States with obstetric, maternal-fetal medicine, and radiology providers who interpreted obstetric ultrasound studies. Themes around barriers/facilitators for fetal heart screening were coded from transcripts. A national Web-based survey was then conducted, which quantitatively measured reported barriers/facilitators and measured physicians' ability to interpret fetal heart-screening images. Multivariable generalized linear random-effect models assessed the association between barriers/facilitators and the accuracy of image interpretation at the image level. RESULTS Three main themes were identified in the focus groups: intrinsic barriers (ie, comfort with screening), external barriers (ie, lack of feedback), and organizational barriers (ie, study volumes). Among 190 physician respondents, 104 interpreted ultrasound studies. Perceptions of barriers varied by practice setting, with nontertiary providers having lower self-efficacy and perceived usefulness of cardiac screening. Facilitators associated with the odds of accurate interpretation of screening images were knowledge (odds ratio, 2.54; P = .002) and the volume of scans per week (odds ratio, 1.01 for every additional scan; P = .04). CONCLUSIONS Some of the main barriers to cardiac screening identified and prioritized by physicians across the United States were knowledge of screening and minimal volumes of scans. Targeting these barriers will aid in improving prenatal detection of congenital heart disease.
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Affiliation(s)
- Nelangi M Pinto
- Division of Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Kevin A Henry
- Department of Geography, Temple University, Philadelphia, Pennsylvania, USA
| | - William A Grobman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Amen Ness
- Department of Obstetrics and Gynecology, Stanford University, Palo Alto, California, USA
| | - Stephen Miller
- Division of Pediatric Cardiology, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sarah Ellestad
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Nina Gotteiner
- Division of Pediatric Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Theresa Tacy
- Division of Cardiology, Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Guo Wei
- Division of Biostatistics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - L LuAnn Minich
- Division of Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Anita Y Kinney
- Department of Biostatistics and Epidemiology, School of Public Health, and Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey, USA
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Pinto NM, Henry KA, Wei G, Sheng X, Green T, Puchalski MD, Byrne JLB, Kinney AY. Barriers to Sonographer Screening for Fetal Heart Defects: A U.S. National Survey. Fetal Diagn Ther 2019; 47:188-197. [PMID: 31416072 DOI: 10.1159/000501430] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/07/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We surveyed obstetric sonographers, who are at the forefront of the screening process to determine how barriers to prenatal cardiac screening impacted screening abilities. METHODS We performed a cross-sectional national survey of obstetric sonographers in the United States using a sampling frame from American Registry of Diagnostic Medical Sonography mailing lists. The web survey measured the ability to obtain and interpret fetal heart images. Several cognitive, sociodemographic, and system-level factors were measured, including intention to perform cardiac imaging. Regression and mediation analyses determined factors associated with intention to perform and ability to obtain and interpret cardiac images. Subgroup analyses of sonographers in tertiary versus nontertiary centers were also performed. RESULTS Survey response rate either due to noncontact or nonresponse was 40%. Of 480 eligible sonographers, ~30% practiced in tertiary settings. Sonographers had lower intention to perform outflow views compared to 4 chambers. Higher self-efficacy and professional expectations predicted higher odds of intention to perform outflow views (OR 2.8, 95% CI 1.9-4.2 and 1.9, 95% CI 1.1-3.0, respectively). Overall accuracy of image interpretation was 65% (±14%). For the overall cohort and nontertiary subgroup, higher intention to perform outflows was associated with increased accuracy in overall image interpretation. For the tertiary subgroup, self-efficacy and feedback were strongly associated with accuracy. CONCLUSIONS We identified several modifiable (some heretofore unrecognized) targets to improve prenatal cardiac screening. Priorities identified by sonographers that are associated with screening success should guide future interventions.
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Affiliation(s)
- Nelangi M Pinto
- Department of Pediatrics, Division of Cardiology, University of Utah, Salt Lake City, Utah, USA,
| | - Kevin A Henry
- Department of Geography, Temple University, Philadelphia, Pennsylvania, USA
| | - Guo Wei
- Department of Pediatrics, Division of Biostatistics, University of Utah, Salt Lake City, Utah, USA
| | - Xiaoming Sheng
- Department of Pediatrics, Division of Biostatistics, University of Utah, Salt Lake City, Utah, USA
| | - Tom Green
- Department of Pediatrics, Division of Biostatistics, University of Utah, Salt Lake City, Utah, USA
| | - Michael D Puchalski
- Department of Pediatrics, Division of Cardiology, University of Utah, Salt Lake City, Utah, USA
| | - Janice L B Byrne
- Department of Internal Medicine, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA
| | - Anita Y Kinney
- School of Public Health and Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey, USA
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Cornelissen MJ, Apon I, van der Meulen JJNM, Groenenberg IAL, Kraan-van der Est MN, Mathijssen IMJ, Bonsel GJ, Cohen-Overbeek TE. Prenatal ultrasound parameters in single-suture craniosynostosis. J Matern Fetal Neonatal Med 2017; 31:2050-2057. [PMID: 28553772 DOI: 10.1080/14767058.2017.1335706] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Although single-suture craniosynostosis is diagnosed sporadically during pregnancy, timely referral is critical for its treatment. Additionally, craniosynostosis leads to increased maternofetal trauma during birth. In the Netherlands, 95% of pregnant women receive a standard ultrasound at around 20 weeks of gestation, potentially an ideal setting for detecting craniosynostosis prenatally. To enhance the prenatal detection of the metopic and the sagittal suture synostosis, we wished to identify new screening parameters. MATERIALS AND METHODS We retrospectively analyzed data of the 20-week anomaly scan in trigonocephaly patients (n = 41), scaphocephaly patients (n = 41), and matched controls (n = 82). We measured six different cranial dimensions, including head circumference, biparietal diameter, and occipito-frontal diameter, defining the cephalic index as the ratio between biparietal and occipito-frontal diameter. RESULTS Prenatal biometric measurements did not differ significantly between trigonocephaly patients and controls. Although significantly lower in scaphocephaly patients (0.76 versus 0.79; p = .000), the cephalic index by itself is not appropriate for screening at 20 weeks of gestation. Longitudinal analysis suggests that a deflection in BPD curve is found in scaphocephaly patients, starting at 20 weeks of gestation. CONCLUSIONS Prenatal biometric measurements do not differ significantly between trigonocephaly patients and controls. The CI is lower in scaphocephaly patients. A deflection in BPD curve should be followed by 3 D imaging of the cranial sutures.
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Affiliation(s)
- Martijn J Cornelissen
- a Department of Plastic and Reconstructive Surgery and Handsurgery , Erasmus MC , Rotterdam , The Netherlands
| | - Inge Apon
- a Department of Plastic and Reconstructive Surgery and Handsurgery , Erasmus MC , Rotterdam , The Netherlands
| | | | - Irene A L Groenenberg
- b Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine , Erasmus MC , Rotterdam , The Netherlands
| | | | - Irene M J Mathijssen
- a Department of Plastic and Reconstructive Surgery and Handsurgery , Erasmus MC , Rotterdam , The Netherlands
| | - Gouke J Bonsel
- b Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine , Erasmus MC , Rotterdam , The Netherlands
| | - Titia E Cohen-Overbeek
- b Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine , Erasmus MC , Rotterdam , The Netherlands
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