Ultraschall Med 2015; 36(05): 473-479
DOI: 10.1055/s-0034-1366880
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Semi-Automatic Identification of the Fetal Profile and Nasal Bone Measurement at the Time of the Routine Mid-Trimester Ultrasound Scan

Semiautomatische Identifikation des fetalen Profils und Messung des Nasenbeinknochens zum Zeitpunkt des Zweittrimesterultraschalls
A. Weichert
1   Department of Obstetrics, Charité – Universitätsmedizin Berlin, Germany
,
J. Neymeyer
2   Department of Urology, Charité – Universitätsmedizin Berlin, Germany
,
L. Hinkson
1   Department of Obstetrics, Charité – Universitätsmedizin Berlin, Germany
,
T. M. Weichert
3   Department of Pediatrics, Sana Klinikum Lichtenberg, Berlin, Germany
,
D. Schmiedel
1   Department of Obstetrics, Charité – Universitätsmedizin Berlin, Germany
,
K. D. Kalache
1   Department of Obstetrics, Charité – Universitätsmedizin Berlin, Germany
› Author Affiliations
Further Information

Publication History

09 February 2014

17 June 2014

Publication Date:
29 July 2014 (online)

Abstract

Purpose: This study was designed to compare nasal bone length (NBL) measurements using a manual multiplanar mode with those made using a newer semi-automatic technique (Volume NT™) acquired by an experienced operator as well as measurements done by two independent observers with different levels of ultrasound experience (conventional 2 D vs. Volume NT™).

Materials and Methods: Ultrasound examination was performed prospectively on 81 pregnant women with a singleton pregnancy at the time of their routine mid-trimester ultrasound scan.

Results: The correct mid-sagittal plane of the fetal profile was successfully obtained using the semi-automatic technique in 53 of 81 cases.

Conclusion: NBL measurements using conventional two-dimensional techniques showed significantly higher inter-observer variability than the semi-automatic program. Our study shows the feasibility of using a semi-automatic technique, especially for less experienced operators. Measurements obtained with the semi-automatic technique produced much less variable results around a mean than those obtained with conventional two-dimensional ultrasound.

Zusammenfassung

Ziel: Ziel der vorliegenden Studie war der Vergleich von Messungen des Nasenbeins mittels manuell durchgeführten Multiplanar-Modus mit den Nasenbeinmessungen, die mittels einer neuen semiautomatischen Technik (Volume NT™) von einem erfahrenen Untersucher gewonnen wurden, sowie Messungen zweier unabhängiger Untersucher mit unterschiedlichem Erfahrungsgrad (konventioneller 2D-Ultraschall vs. Volume NT™).

Material und Methoden: Ultraschalluntersuchungen wurden prospektiv bei 81 Schwangeren mit einer Einlingsschwangerschaft zum Zeitpunkt des Zweittrimesterultraschalls durchgeführt.

Ergebnisse: Die genaue Midsagittalebene wurde mit dem semiautomatischen Verfahren erfolgreich bei 53 der 81 untersuchten Fälle gewonnen.

Schlussfolgerungen: Messungen des Nasenbeins mittels konventionellen zweidimensionalen Ultraschalls ergaben eine signifikant höhere Interobserver-Variabilität als die, die mittels semiautomatischen Verfahrens gewonnen wurden. Unsere Studie belegt die Durchführbarkeit eines semiautomatischen Verfahrens, insbesondere bei Anwendern mit geringerer Erfahrung. Messungen, die mittels semiautomatischen Verfahrens gewonnen wurden, ergaben eine deutlich geringere Streuung um den Median als die Ergebnisse, die durch konventionellen 2D-Ultraschall gewonnen wurden.

 
  • References

  • 1 Jones KL, Smith DW. Smith's recognizable patterns of human malformation. 6. ed. Philadelphia: Pa.: Elsevier Saunders; 2006
  • 2 Salomon LJ, Alfirevic Z, Berghella V et al. Practice guidelines for performance of the routine mid-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol 2011; 37: 116-126
  • 3 Cohen Jr MM. Syndromology: an updated conceptual overview. IX. Facial dysmorphology. Int J Oral Maxillofac Surg 1990; 19: 81-88
  • 4 Nicolaides KH, Salvesen DR, Snijders RJ et al. Fetal facial defects: associated malformations and chromosomal abnormalities. Fetal Diagn Ther 1993; 8: 1-9
  • 5 De Jong-Pleij EA, Vos FI, Ribbert LS et al. Prenasal thickness-to-nasal bone length ratio: a strong and simple second- and third-trimester marker for trisomy 21. Ultrasound Obstet Gynecol 2012; 39: 185-190
  • 6 Benacerraf BR. The role of the second trimester genetic sonogram in screening for fetal Down syndrome. Semin Perinatol 2005; 29: 386-394
  • 7 Bahado-Singh RO, Oz UA, Mendilcioglu I et al. The mid-trimester genetic sonogram. Semin Perinatol 2005; 29: 209-214
  • 8 Persico N, Molina F, Borenstein M et al. Nasal-bone length in euploid fetuses at 16-24 weeks' gestation by three-dimensional ultrasound. Ultrasound Obstet Gynecol 2010; 36: 285-290
  • 9 De Jong-Pleij EA, Ribbert LS, Tromp E et al. Three-dimensional multiplanar ultrasound is a valuable tool in the study of the fetal profile in the second trimester of pregnancy. Ultrasound Obstet Gynecol 2010; 35: 195-200
  • 10 Snijders RJ, Noble P, Sebire N et al. UK multicentre project on assessment of risk of trisomy 21 by maternal age and fetal nuchal-translucency thickness at 10-14 weeks of gestation. Fetal Medicine Foundation First Trimester Screening Group. Lancet 1998; 352: 343-346
  • 11 Herman A, Dreazen E, Maymon R et al. Implementation of nuchal translucency image-scoring method during ongoing audit. Ultrasound Obstet Gynecol 1999; 14: 388-392
  • 12 Braithwaite JM, Kadir RA, Pepera TA et al. Nuchal translucency measurement: training of potential examiners. Ultrasound Obstet Gynecol 1996; 8: 192-195
  • 13 Cho HY, Kwon JY, Kim YH et al. Comparison of nuchal translucency measurements obtained using Volume NT(TM) and two- and three-dimensional ultrasound. Ultrasound Obstet Gynecol 2012; 39: 175-180
  • 14 Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307-310
  • 15 Sonek JD, McKenna D, Webb D et al. Nasal bone length throughout gestation: normal ranges based on 3537 fetal ultrasound measurements. Ultrasound Obstet Gynecol 2003; 21: 152-155
  • 16 Ramos GA, Kfir M, Lee S et al. Benefits of a systematic approach in the evaluation of fetal facial 3-dimensional volumes. J Ultrasound Med 2011; 30: 473-479
  • 17 Lauersen NH, Hochberg HM. Automatic detection of fetal movement by Doppler ultrasound during non-stress testing. Int J Gynaecol Obstet 1982; 20: 219-222
  • 18 Thomas JG, Jeanty P, Peters RA et al. Automatic measurements of fetal long bones. A feasibility study. J Ultrasound Med 1991; 10: 381-385
  • 19 Espinoza J, Good S, Russell E et al. Does the use of automated fetal biometry improve clinical work flow efficiency?. J Ultrasound Med 2013; 32: 847-850
  • 20 Abuhamad A. Automated multiplanar imaging: a novel approach to ultrasonography. J Ultrasound Med 2004; 23: 573-576
  • 21 Abuhamad A, Falkensammer P, Zhao Y. Automated sonography: defining the spatial relationship of standard diagnostic fetal cardiac planes in the second trimester of pregnancy. J Ultrasound Med 2007; 26: 501-507
  • 22 Goncalves LF, Lee W, Espinoza J et al. Three- and 4-dimensional ultrasound in obstetric practice: does it help?. J Ultrasound Med 2005; 24: 1599-1624
  • 23 Goncalves LF, Espinoza J, Romero R et al. Four-dimensional fetal echocardiography with spatiotemporal image correlation (STIC): a systematic study of standard cardiac views assessed by different observers. J Matern Fetal Neonatal Med 2005; 17: 323-331