| Autor: |
Ibarra Vilar, Patricia, De Luca, Laura, Badr, Dominique A., Cos Sanchez, Teresa, Carlin, Andrew, Lecomte, Sophie, Jani, Jacques C., Kang, Xin |
| Zdroj: |
Prenatal Diagnosis; Jan2024, Vol. 44 Issue 1, p15-27, 13p |
| Abstrakt: |
Objective: To determine the learning curve of fetal postmortem ultrasound (PMUS) and evaluate the evolution of its diagnostic performance over the past 8 years. Methods: PMUS was performed by two fetal medicine specialists and two experts on 100 unselected fetuses of 12–38 weeks of gestation in a prospective, double‐blind manner. 21 pre‐defined internal structures were analyzed consecutively by the trainee alone and the expert, with a comparison of diagnosis and immediate feedback. The learning curves for examination duration, non‐recognition of structures and final diagnoses were computed using cumulative summation analysis. Secondly, the expert PMUS diagnostic accuracy using autopsy as the gold standard was compared to the previously published data. Results: The trainees reached expert level of PMUS at 28–36 cases for examination duration (12.1 ± 5.2 min), non‐diagnostic rate (6.5%, 137/2100), and abnormality diagnosis. In a group of 33 fetuses ≥20 weeks who had an autopsy, the experts PMUS performance was improved after 8 years with a reduction of all organs non‐diagnostic rate (6.5 %VS 11.4%, p < 0.01) and higher sensitivity for the heart (100% VS 40.9%, p < 0.01) and the abdomen (100%VS 56.5%, p < 0.05). Conclusion: PMUS offers a short learning curve for fetal medicine specialists and on‐going improvement of diagnostic accuracy over time. Key points: What's already known about this topic? Fetal postmortem imaging has emerged to propose less invasive alternatives to invasive autopsy because of the decline of parental consent.Fetal postmortem ultrasound (PMUS) is a fetal postmortem imaging technique with sensitivity of 74.7% and a specificity of 83.3% for the examination of all gestational age (GA) fetuses.PMUS is less expensive and more easily accessible compared with other fetal postmortem imaging techniques such as Postmortem magnetic resonance imaging (PMMRI). What does this study add? Less than 40 cases were needed by fetal medicine specialists to reach expert‐level PMUS performance for the examination duration, recognition of structures and abnormality diagnosis.The expert PMUS diagnostic accuracy is improved overtime with lower non‐diagnostic image rate and higher sensitivity for cardiac and abdominal examinations. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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