Daniela de Abreu Barra

Reliability and validity of tissue volume measurement by three-dimensional ultrasound: an experimental model

To determine the validity and the intra‐ and interobserver reliability of volume measurements of an endometrium‐like model using a three‐dimensional (3D) ultrasound rotational technique.

Lower uterine segment thickness measurement in pregnant women with previous Cesarean section: reliability analysis using two- and three-dimensional transabdominal and transvaginal ultrasound

To evaluate the reliability of two‐ and three‐dimensional ultrasonographic measurement of the thickness of the lower uterine segment (LUS) in pregnant women by transvaginal and transabdominal approaches.

Litíase vesicular assintomática em mulheres: aspectos epidemiológicos e clínicos

RESUMO: Objetivo: Analisar variaveis clinicas e ultra-sonograficas como presenca ou ausencia de barro biliar, espessura da parede e medida transversal da vesicula biliar, idade, paridade, presenca ou ausencia de diabetes melitus associadas a litiase vesicul ar assintomatica, bem como determinar a sua prevalencia em pacientes submetidas ao exame ultra-sonografico. Metodo: Foram analisadas, em estudo prospectivo, 265 pacientes do sexo feminino, atendidas na Escola de Ultra-sonografia e Reciclagem Medica de Ribeirao Preto - EURP, durante o periodo de janeiro a setembro de 2001. Resultados: Evidenciou-se diferenca estatisticamente significativa relacionada a litiase da vesicula biliar e: espessura da parede da vesicula biliar, barro biliar, diâmetro transv erso da vesicula biliar, faixa etaria, paridade, passando de 4,1% na nuliparas, para 39,1% nas multiparas e diabeticas. A prevalencia d e litiase na vesicula biliar, em pacientes assintomaticas, foi de 14.7%. Conclusao: A litiase vesicular assintomatica em mulheres ocorre principalmente com o decorrer da idade e da paridade. Os achados ultra-sonograficos mais frequentemente encontrados foram: presenca de barro biliar e de espessamento da parede da vesicula biliar (Rev. Col. Bras. Cir. 2006; 33(4): 235-241).

Medida da espessura do segmento uterino inferior em gestantes com cesárea prévia: análise da reprodutibilidade intra- e interobservador por ultra-sonografia bi- e tridimensional

PuRPOse: to compare the intra and interobserver reproducibility of the total thickness measurement of the inferior uterine segment (IUS), through the abdominal route, and of the muscle layer measurement, through the vaginal route, using bi and tridimensional ultrasonography. MethOds: the IUS thickness measurement of 30 women, between the 36 th and 39 th weeks of gestation with previous caesarean section, done by two observers, was studied. Abdominal ultrasonography with the patient in both supine and lithotomy position was performed. In the sagittal section, the IUS was identified and four bidimensional images and two tridimensional blocks of the total thickness were collected through the abdominal route, and the same for the muscle layer, through the vaginal route. Tridimensional acquisitions were manipulated in the multiplanar mode. The time was measured with a chronometer. Reproducibility was evaluated by the computation of the absolute difference between measurements, the ratio of differences smaller than 1 mm, the intraclass coefficient (ICC), and the Bland and Altman’s concordance limits. Results: the average bidimensional measurement

Advanced Topics on Three-dimensional Ultrasound in Obstetrics and Gynecology

It is important to know how three-dimensional ultrasound (3DUS) works and its functions for making the best use of 3DUS. 3DUS shows various kinds of images through following processes: 1. Acquisition of 3D data (3D scanning) A large number of consecutive tomographic (2D) images are obtained through 3D scanning with a 3D probe; 2. Construction of a 3D data set A 3D data set is constructed from the acquired 2D images. A gated technique called STIC (spatiotemporal image correlation) is used for construction of 3D data sets of the fetal heart; 3. Volume visualization A computer constructs 2D and 3D images from the 3D data set. 3DUS shows multiplanar images, such as a multi-parallel-plane image and a three-orthogonal-plane image. Each plane can be selected arbitrarily by translation and rotation of the 3D data set. Most of 3D images are constructed by volume rendering. Proper settings of ROI (region of interest) and threshold are important for obtaining a clear surface rendered image. Electrical scalpel (or “MagiCut”) is used to eliminate unfavorable structures around the object. Various kinds of 3D images as well as a surface rendered image can be obtained by volume rendering. Surface rendering is also used for 3D image construction. Boundaries of the object should be outlined strictly and it takes a lot of time to get a 3D image in surface rendering. But once the object is extracted, the volume of the object can be calculated.

P28.12: Fetal volume in the first gestational trimester by three‐dimensional ultrasonography: intra‐ and inter‐observer reliability and agreement

Objectives: To estimate and compare the spent time and the intra/inter-observer reliability and agreement from methods of measuring fetal head and trunk volume (FV) between 11w0d and 13w6d. Methods: 2 observers measured FV from fetuses with crownrump length (CRL) = 45–84 mm. FV was measured using 30◦ step rotation evaluating unmodified multiplanar view (UMV = just placing the fetal chest on the central point) delineating the fetus in any plane, and standardized multiplanar view (SMV = fetal sagittal plane should in A plan, head to the left, back lying down, with the central point just below fetal heart) delineating the fetus in both A (SMV-A = fetus rotated over its small axis) and C plane (SMV-C = fetus rotated over its long axis). We also evaluate whether reducing step rotation using 15◦ and 9◦ could improve reliability/agreement using only the method with the best results in the first part of the study. We used Kolmogorov-Smirnov; repeated measures ANOVA to assess systematic errors and time spent; intraclass correlation coefficient (ICC) to assess reliability; and limits of agreement (LoA) width to assess agreement. Results: 40 fetuses were examined. No systematic errors were observed. Reliability and agreement were better for SMV-C. Reducing step rotation didn’t improve the results (table 1). Less time was spent using UMV and larger rotation steps. Conclusions: SMV-C using 30◦ was the best method to assess FV.