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DOI: 10.1055/s-0029-1241030
© Georg Thieme Verlag KG Stuttgart · New York
Reproduzierbarkeit Doppler-sonografischer Messungen der fetalen Zerebralvenen: Eine Studie am Sinus transversus
Reproducibility of Doppler Sonography Measurements of Fetal Cerebral Veins: a Study of the Transverse SinusPublikationsverlauf
eingereicht 28.12.2009
revidiert 20.1.2010
akzeptiert 28.1.2010
Publikationsdatum:
14. April 2010 (online)
![](https://www.thieme-connect.de/media/gebfra/201004/lookinside/thumbnails/10.1055-s-0029-1241030-1.jpg)
Zusammenfassung
Fragestellung: Ziel dieser Studie war es, die Perfusion und die Reproduzierbarkeit des Pulsatility Index (PI) im Sinus transversus (ST) des Fetus zu analysieren. Material und Methodik: Wir schlossen 138 konsekutive Doppler-Messungen des fetalen Sinus transversus in unsere Studie ein. Die Reproduzierbarkeit wurde durch 2- bis 5-maliges Messen des PI analysiert. Wir berechneten die prozentuelle Abweichung des PI, indem wir den Variationskoeffizienten und den Single-Measure-Interclass-Koeffizienten zur Auswertung heranzogen. Ergebnisse: Wir konnten den PI in 119 von 138 Fällen berechnen. In 14 Fällen erhielten wir keine zufriedenstellende Qualität des Doppler-Signals. In weiteren 3 Fällen konnten wir das Doppler-Signal dem Herzzyklus nicht ausreichend zuordnen und in 2 weiteren Fällen fanden wir ein laminares Flussmuster ohne Pulsationen von sehr geringer Geschwindigkeit, welches ungeeignet für die Messung des PI war. In den verwertbaren Messungen zeigte sich Folgendes: 25 % der Messungen wiesen einen Variationskoeffizienten von 0–10 % auf, 32 % hatten einen Variationskoeffizienten von 10–20 % und bei 43 % lag der Variationskoeffizient über 20 %. Der Single-Measure-Interclass-Koeffizient betrug bei unseren Daten 0,63 (0,27–0,91). Schlussfolgerung: Die hämodynamische Situation im fetalen Sinus transversus mit sehr langsamen Fließgeschwindigkeiten gestaltet die Doppler-Untersuchungen dieses Gefäßes in einem klinischen Setting schwierig. Die Variabilität des PI im Sinus transversus unterliegt einer großen Schwankungsbreite und erscheint somit für eine diagnostische Anwendung limitiert zu sein.
Abstract
Purpose: The aim of this study was to analyse the perfusion and reproducibility of the Pulsatility Index (PI) from recordings of the transverse sinus (TS) in the fetus. Material and Methods: We included 138 consecutive recordings from the TS. Wave-form analysis was performed by measuring the PI 2–5 times. We calculated the percent deviation of PI measurements using the variation coefficient and the single measure intraclass coefficient. Results: We were able to calculate a PI in 119/138 cases. In 14 cases we were unable to obtain any Doppler recording of sufficient quality. In another 3 cases we could not identify the heart cycle precisely and in two further cases we found a continuous flow pattern with very low velocities not suitable for PI calculation. In the remaining recordings 25 % of the measurements had a variation coefficient of between 0–10 %, 32 % of between 10–20 % and 43 % had a variation coefficient of 20 % or above. The single measure intraclass coefficient was 0.63 (0.27–0.91). Conclusion: The hemodynamic situation with very low velocities in the fetal TS makes it difficult to record wave forms in a clinical setting. The variation of the PI in the transverse sinus is high and appears to limit its diagnostic use.
Schlüsselwörter
Sinus transversus - zerebrale venöse Perfusion - Reproduzierbarkeit - fetaler Doppler - Pulsatility Index
Key words
transverse sinus - cerebral venous perfusion - reproducibility - fetal Doppler - Pulsatility Index
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Dr. med. Christoph Stierle
Abteilung für Gynäkologie und Geburtshilfe
Paracelsus Medizinische Privatuniversität, Salzburg
Müllner Hauptstraße 48
5020 Salzburg
Österreich
eMail: c.stierle@salk.at