北京大学学报(医学版) ›› 2013, Vol. 45 ›› Issue (6): 896-900.

• 论著 • 上一篇    下一篇

经阴道二维超声与三维超声进行卵巢窦卵泡计数观察者间的可靠性比较

张佳妮1,史铁梅2△   

  1. (1.心功能科,2.超声科,中国医科大学附属盛京医院,沈阳110004)
  • 出版日期:2013-12-18 发布日期:2013-12-18

Reliability of antral follicle counts using transvaginal two- and three- dimensional sonography

ZHANG Jia-ni1, SHI Tie-mei2△   

  1.  (1. Department of Cardiac Function, 2. Department of Ultrasound Function, Shengjing Hospital of China Medical University, Shenyang 110004, China)
  • Online:2013-12-18 Published:2013-12-18

摘要: 目的:评价经阴道二维超声进行卵巢窦卵泡计数(antral follicle counts, AFC)观察者间结果的一致性。方法:两名观察者通过经阴道超声对51名不孕女性患者于月经周期的卵泡早期计数窦卵泡。用二维超声进行AFC,并记录所用时间;存储每个卵巢的三维信息,后续通过多平面模式计数窦卵泡。记录三维超声每个步骤所用的时间,计算出总时间。通过组内相关系数(intraclass correlation coefficients, ICC)和Bland-Altman图的一致性限度(limits of agreement, LOA)来评估两种计数方法的可靠性。结果:二维超声和三维超声计数窦卵泡的平均值差异无统计学意义,分别为(18.63±11.39)个和(18.73±11.41)个。三维超声的ICC优于二维超声;三维超声的ICC:平均值0.994,95%可信区间(0.990,0.997);二维超声的ICC:平均值0.979,95%可信区间(0.963,0.988),P<0.01。BlandAltman图中,三维超声的LOA比二维超声范围小,分别为(-3.46,3.35)和(-6.78,6.31);而三维超声所用的总时间比二维超声长得多,分别为(204.0±53.0)s和(112.4±34.8)s,P<0.001;但受试者的暴露时间三维超声要远远短于二维超声,分别为(48.0±7.5) s和(112.4±34.8) s,P<0.001。结论:三维超声明显改善了窦卵泡计数的观察者间的可靠性,却增加了计数总时间,但与实时二维超声相比,大大缩短了受试者检查暴露的时间。

关键词: 超声检查, 成像, 三维, 卵泡, 观察者偏差

Abstract: To assess the interobserver reliability of antral follicle counts (AFC) using real-time two-dimensional (2D) ultrasound and three-dimensional (3D) ultrasound. Methods: Two observers conducted transvaginal ultrasound examinations in 51 subfertile women in the early follicular phase of the menstrual cycle. Antral follicles were counted using real-time 2D ultrasound and the time taken was recorded. A 3D volume was then acquired from each ovary and stored for subsequent offline analysis using the multiplanar view. The time taken for each step was recorded and the total time was calculated. Intraclass correlation coefficients (ICC) and limits of agreement were used to assess the reliability. Results: There was no difference in the mean antral follicle counts using real-time 2D (18.63±11.39) and 3D (18.73±11.74) ultrasound. According to the ICC, there was a significantly higher interobserver reliability for counts made using 3D (mean, 0.994; 95% CI, 0.990-0.997) as compared with real-time 2D ultrasound (mean, 0.979; 95% CI, 0.963-0.988), P<0.01. 3D ultrasound was also associated with narrower limits of agreement (-3.46, 3.35) than was 2D ultrasound (-6.78, 6.31). While the total time taken was significantly longer for the 3D technique [(204.0±53.0) s  vs. (112.4±34.8) s, P<0.001], the time required for the actual ultrasound examination was significantly less [(48.0±7.5) s  vs. (112.4±34.8) s, P<0.001].Conclusion: 3D ultrasound significantly improves the interobserver reliability of antral follicle counts. While this is at the expense of time overall, the duration of the actual ultrasound examination and the patient exposure is significantly reduced using 3D compared with real-time 2D ultrasound.

Key words: Ultrasonography, Imaging, three-dimensional, Ovarian follicle, Observer variation

[1] 傅强,高冠英,徐雁,林卓华,孙由静,崔立刚. 无症状髋关节前上盂唇撕裂超声与磁共振检查的对比研究[J]. 北京大学学报(医学版), 2023, 55(4): 665-669.
[2] 王昱,张慧敏,邓雪蓉,刘伟伟,陈璐,赵宁,张晓慧,宋志博,耿研,季兰岚,王玉,张卓莉. 尿枸橼酸定量检测在原发性痛风患者肾结石诊断中的应用价值[J]. 北京大学学报(医学版), 2022, 54(6): 1134-1140.
[3] 邓雪蓉,孙晓莹,张卓莉. 类风湿关节炎患者足踝部体征和超声下病变的一致性[J]. 北京大学学报(医学版), 2021, 53(6): 1037-1042.
[4] 杨广鑫,栾景源,贾子昌. 静脉造影和超声联合引导射频闭合治疗下肢静脉曲张[J]. 北京大学学报(医学版), 2021, 53(2): 332-336.
[5] 王昱,邓雪蓉,季兰岚,张晓慧,耿研,张卓莉. 超声检测痛风患者肌腱受累的危险因素和诊断价值[J]. 北京大学学报(医学版), 2021, 53(1): 143-149.
[6] 徐涛,韩敬丽,姚伟娟. 雄激素剥夺治疗相关心血管疾病的机制与临床对策[J]. 北京大学学报(医学版), 2020, 52(4): 607-609.
[7] 宁晓然,王子乔,张珊珊,张霞,唐素玫,刘燕鹰. 超声评分系统在IgG4相关涎腺炎评估中的应用[J]. 北京大学学报(医学版), 2019, 51(6): 1032-1035.
[8] 李宁宁,季丽娜,晁爽,袁珂,孟洪,黄振宇,张华斌. 新生儿先天性肾脏和泌尿道畸形的超声筛查及随访[J]. 北京大学学报(医学版), 2019, 51(6): 1062-1066.
[9] 付鹏,陈文,崔立刚,葛辉玉,王淑敏. 2017版美国放射学会甲状腺影像学报告与数据系统应用价值探索[J]. 北京大学学报(医学版), 2019, 51(6): 1067-1070.
[10] 刘畅, 崔立刚, 王宏磊. 肾尤文氏肉瘤/原始神经外胚层肿瘤: 1例报道并文献复习[J]. 北京大学学报(医学版), 2017, 49(5): 919-923.
[11] 许挺,李民,田杨,宋金涛,倪诚,郭向阳. 超声引导下平面内经外侧肋间入路行胸椎旁阻滞的临床评价[J]. 北京大学学报(医学版), 2017, 49(1): 148-152.
[12] 徐林, 陈方民, 王蕾, 张培训, 姜晓锐. 高频超声测量腕横韧带厚度对腕管综合征的临床辅助诊断价值[J]. 北京大学学报(医学版), 2016, 48(2): 341-345.
[13] 蒋洁,崔立刚, 王金锐, 江凌, 李志强, 赵博. 胸大肌的超声解剖及其撕裂的声像图特点[J]. 北京大学学报(医学版), 2016, 48(1): 166-169.
[14] 王昱,耿研,邓雪蓉,张卓莉. 女性类风湿关节炎患者手腕骨密度检查与超声腕关节骨侵蚀及炎症评分的相关性[J]. 北京大学学报(医学版), 2015, 47(5): 774-780.
[15] 马凯, 黄晓波, 熊六林, 许清泉, 徐涛, 叶海云, 于路平, 王晓峰. 新型超声导航系统引导经皮肾穿刺行经皮肾镜取石术16例[J]. 北京大学学报(医学版), 2014, 46(4): 563-565.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!