Three-dimensional ultrasonographic placental volume in gestational diabetes mellitus

Objectives: We aimed to evaluate the placental volume and placental mean gray value in gestational diabetes mellitus (GDM) and healthy placentas using three-dimensional (3D) ultrasound and Virtual Organ Computer-aided AnaLysis (VOCAL).

Methods: This case-control prospective study consisted of 39 singleton pregnancies complicated by GDM and 42 healthy singleton pregnancies matched for gestational age, maternal age and parity. Placental volume and placental volumetric mean gray values were evaluated. The placental volume (cm³) was analyzed using the VOCAL imaging analysis program and 3D histogram was used to calculate the volumetric mean gray value (%).

Results: Placental volume was significantly larger in GDM (411.59?±?170.82 versus 343.86?±?128.94?cm³; p?=?0.046). There was no significant difference in mean gray value between GDM and healthy placentas (36.65?±?7.02 versus 38.71?±?7.91, respectively; p?=?0.277). Placental volume was significantly correlated with gestational week (r?=?0.219, p?=?0.035) and parity (r?=?0.228, p?=?0.048). There was negative significant relation between placental volume and umbilical artery systolic/diastolic ratio, pulsatility index and resistance index (r?=??0.278, p?=?0.007; r?=??0.315, p?=?0.002; r?=??0.322, p?=?0.001, respectively).

Conclusions: Placental volume increases significantly in GDM, whereas mean gray values do not alter significantly. These data may reflect the placental changes in GDM placentas that may help to understand the pathophysiology better.     

三维超声在乳腺癌新辅助化疗疗效评估中的应用价值

目的：探讨在乳腺癌新辅助化疗疗效的评估中,三维超声成像技术的应用价值。方法方便选取该院2015年1月—2016年5月确诊为乳腺癌并且行新辅助化疗及手术治疗的30例患者为研究对象。根据化疗前后乳腺肿物变化的三维超声评估与病理结果相比较。结果研究组中30个病例中接受TAC后,乳腺癌三维超声评分观察值减小21例(70%),2例(6.67%)乳腺癌原发病灶消失。7例乳腺癌原发病灶无变化,占23.3%;三维超声诊断与病理学评价结果基本一致,P>0.05;二维超声成像评价与病理学评价结果相比差异有统计学意义(P<0.05);三维超声及二维超声在灵敏度、特异度、准确率上差异有统计学意义。结论在乳腺癌新辅助化疗中三维超声有助于化疗疗效的评估。     

三维超声VOCAL技术评价胎儿肺发育不良的临床价值研究

目的：探讨应用三维超声VOCAL技术评价胎儿肺发育不良的临床价值。方法方便选择在2015年1月—2016年1月该院门诊接受常规检查的320例孕周为16~37周正常单胎妊娠孕妇以及12例超声检查发现胎儿肺发育不良的高危孕妇作为研究对象,对所有研究对象的胎儿进行肺三维超声体积检查,使用VOCAL技术测定胎儿左右肺的体积,分析左右肺和总肺的体积与孕周之间的关系。结果正常妊娠胎儿的左右肺和总肺体积均与孕周呈高度相关的关系（P﹤0.001)。超声诊断结果、临床诊断结果以及病理诊断结果均基本符合。结论三维超声VOCAL技术可为16-37周胎儿提供评估肺发育不良的参考指标。     

Fetal cerebral ventricle volumetry: comparison between 3D ultrasound and magnetic resonance imaging in fetuses with ventriculomegaly

Objectives.?The aim of this study was to evaluate feasibility of fetal lateral ventricle (LV) volumetry in fetuses with ventriculomegaly and to compare measurements performed by 3D sonographic method virtual organ computer-aided analysis (VOCAL) with those obtained by magnetic resonance imaging (MRI).

Methods.?This cross-sectional study evaluated 30 fetuses with atrial width (AW) between 10 and 30?mm, from 20 to 36 gestational weeks. Fifty-nine ventricles were measured by two observers. Sonographic volumetric measurements using VOCAL 30° were performed with an ACCUVIX XQ machine (Medison, Korea) and MRI assessments with a Sonata system using ARGUS software (Siemens, Germany). Agreement between both techniques was assessed by intraclass correlation coefficient (ICC) calculation, and proportionate Bland–Altman plots were constructed.

Results.?A high degree of reliability was observed between VOCAL and MRI measurements (ICC 0.928, 95%CI [0.876;0.958]). Bland–Altman plots confirmed the high correlation (mean of differences: 1.62 cm³ and standard deviation:?±?8.41 cm³).

Conclusion.?Three-dimensional volumetry of fetal LVs by VOCAL method has good agreement with fetal MRI in fetuses with ventriculomegaly and may be used as an additional tool in patient counseling and prognosis prediction.     

Prediction of abortion using three-dimensional ultrasound volumetry of the gestational sac and the amniotic sac in threatened abortion

PURPOSE.: To determine whether gestational sac volume (GSV) or amniotic sac volume (ASV) and/or the difference between them can predict abortion in women with first-trimester threatened abortion. METHODS.: Ninety patients between 6 and 12 weeks of gestation presenting with vaginal bleeding were studied. Seventy-six delivered after 24 weeks of gestation (group A) and 14 aborted before 20 weeks of gestation (group B). All patients had a singleton viable pregnancy demonstrated by transvaginal ultrasound. Gestational sac and amniotic sac volumes were measured in all the patients using three-dimensional transvaginal ultrasound with Virtual Organ Computer-aided Analysis software, and the gestational sac volume - amniotic sac volume (GSV - ASV) was calculated. RESULTS.: The groups did not differ in terms of age, parity, number of previous abortions, or term deliveries. The GSV (group A: mean 32.0 ± 27.7 cm(3) ; group B: 26.7 ± 29.1 cm(3) ) and the ASV (group A: 21.1 ± 25.5 cm(3) ; group B: 20.6 ± 26.0 cm(3) ) were not statistically different, while the GSV - ASV was significantly smaller in group B (aborting before week 20) (group A: 10.9 ± 10.9 cm(3) ; group B: 6.1 ± 8.6 cm(3) ; p < 0.05). Using receiver operator curves, the area under the curve for predicting normal pregnancy outcome of the GSV - ASV measurement was 0.654. When the GSV - ASV was 1.8 cm(3) or less, abortion was predicted with 84% sensitivity and 43% specificity. CONCLUSIONS.: The measurement of the GSV and the ASV are not good predictors of abortion in patients with first-trimester vaginal bleeding, whereas the use of the GSV - ASV may be helpful in predicting the outcome of pregnancy. ? 2012 Wiley Periodicals, Inc. J Clin Ultrasound 40:389-393, 2012.     

A Novel Technique for the Semi-Automated Measurement of Embryo Volume: An Intraobserver Reliability Study

The aim was to assess intraobserver reliability of a new semi-automated technique of embryo volumetry. Power calculations suggested 46 subjects with viable, singleton pregnancies were required for reliability analysis. Crown rump length (CRL) of each embryo was analyzed using 2-D and a 3-D dataset acquired using transvaginal ultrasound. Virtual organ computer-aided analysis (VOCAL) was used to calculate volume of gestation sac (GSV) and yolk sac (YSV) and SonoAVC (sonography-based automated volume count) was used to quantify fluid volume (FV). Embryo volume was calculated by subtracting FV and YSV from GSV. Each dataset was measured twice. Reliability was assessed using Bland-Altman plots and intraclass correlation coefficients (ICCs). Fifty-two datasets were analyzed. Median embryo volume was 1.8cm³ (0.1 to 8.1 cm³); median gestational age 7 + 4 weeks; median CRL 13 mm (2 to 29 mm). Mean difference of embryo volume measurements was 0.1cm³ (limits of agreement [LOA] –0.3 to 0.4 cm³); multiples of mean (MoM) 0.38; mean difference of CRL measurements 0.3 mm (LOA –1.4 to 2.0 mm), MoM = 0.26. ICC for embryo volume was 0.999 (95%CI 0.998 to 0.999), confirming excellent intraobserver agreement. ICC for CRL was 0.996 (95%CI 0.991 to 0.998). Regression analysis showed good correlation between embryo volume and CRL (R² = 0.60). The new semi-automated 3-D technique provides reliable measures of embryo volume. Further work is required to assess the validity of this technique. (E-mail: shyamaly@doctors.org.uk)     

针刺开音1号穴配合颈夹脊穴治疗声带小结25例临床观察

[目的]观察针刺开音1号穴配合颈夹脊穴治疗声带小结的临床疗效.[方法]将47例声带小结患者随机分为治疗组25例和对照组22例.治疗组以针刺开音1号穴配合颈夹脊穴3～5为主治疗,对照组以口服金嗓散结丸治疗.2组均以20 d为1个疗程.观察2组的临床疗效及安全性.[结果]治疗后治疗组愈显率为56.00%,对照组为36.36%,2组比较差异有显著性意义(P<0.05).治疗组患者治疗后的症状积分有明显改善(与治疗前比较,P<0.05);对照组治疗后的症状积分也有所改善,但与治疗前比较差异无显著性意义(P>0.05).2组治疗后比较差异有显著性意叉(P<0.05),说明治疗组对症状积分的改善作用明显优于对照组.2组病例均未出现任何不良反应.[结论]针刺开音l号穴配合颈夹脊穴为主治疗声带小结是临床安全有效的治法.     

The role of three-dimensional ultrasonography fetal lung volume measurement in the prediction of neonatal respiratory function outcome

Background: Respiratory distress is commonly encountered among premature babies immediately after birth resulting in significant neonatal morbidity or mortality.

Objectives: To evaluate the possible correlation between three dimensional fetal lung volumes (FLVs) and neonatal respiratory outcomes.

Study design: A cohort study included 100 pregnant women who participated in the study and were divided into two groups; group A (n: 50 – women pregnant ±34–37 weeks) and group B (n: 50 – women pregnant ±37⁺¹ to 40 weeks). A three dimensional measurement of the right fetal lung was made using virtual organ computer-aided analysis (VOCAL) software then correlated to neonatal respiratory functions namely Apgar score at birth and the occurrence of respiratory distress syndrome (RDS).

Results: In group A, FLV was negatively correlated with Apgar score and the occurrence of RDS. In group B, FLV showed no statistical correlation with Apgar score and the occurrence of RDS.

Conclusions: Three dimensional fetal lung volumes might be an accurate noninvasive predictor for the development of RDS among preterm fetuses.