Introducing and Validating the Cranial-Dorsal-Hip Angle (∠CDH): A Method for Accurate Fetal Position Assessment in the First Trimester and Future AI Applications.

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Ultrasound International Open Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI:10.1055/a-2337-0078
Ying Tan, Huaxuan Wen, Guiyan Peng, Huiying Wen, Xin Wen, Yao Jiang, Jiaqi Fan, Ying Yuan, Dandan Luo, Shengli Li
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Abstract

Purpose  To introduce the cranial-dorsal-hip angle (∠CDH) as a novel quantitative tool for assessing fetal position in the first trimester and to validate its feasibility for future AI applications. Materials and Methods  2520 first-trimester fetal NT exams with 2582 CRL images (January-August 2022) were analyzed at a tertiary hospital as the pilot group. Additionally, 1418 cases with 1450 fetal CRL images (September-December 2022) were examined for validation. Three expert sonographers defined a standard for fetal positions. ∠CDH measurements, conducted by two ultrasound technicians, were validated for consistency using Bland-Altman plots and the intra-class correlation coefficient (ICC). This method allowed for categorizing fetal positions as hyperflexion, neutral, and hyperextension based on ∠CDH. Comparative accuracy was assessed against Ioannou, Wanyonyi, and Roux methods using the weighted Kappa coefficient (k value). Results  The pilot group comprised 2186 fetal CRL images, and the validation group included 1193 images. Measurement consistency was high (ICCs of 0.993; P<0.001). The established 95% reference range for ∠CDH in the neutral fetal position was 118.3° to 137.8°. The ∠CDH method demonstrated superior accuracy over the Ioannou, Wanyonyi, and Roux methods in both groups, with accuracy rates of 94.5% (k values: 0.874, 95%CI: 0.852-0.896) in the pilot group, and 92.6% (k values: 0.838, 95%CI: 0.806-0.871) in the validation group. Conclusion  The ∠CDH method has been validated as a highly reproducible and accurate technique for first-trimester fetal position assessment. This sets the stage for its potential future integration into intelligent assessment models.

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介绍并验证颅背臀角(∠CDH):妊娠头三个月胎位准确评估方法及未来人工智能应用。
目的 将颅背臀角(∠CDH)作为评估头三个月胎位的新型定量工具,并验证其在未来人工智能应用中的可行性。材料与方法 以一家三甲医院为试验组,分析了 2520 例初产妇胎儿 NT 检查和 2582 张 CRL 图像(2022 年 1 月至 8 月)。此外,还对 1418 个病例的 1450 张胎儿 CRL 图像(2022 年 9 月至 12 月)进行了验证。三位专业超声技师确定了胎位的标准。由两名超声技术人员进行的∠CDH测量使用布兰-阿尔特曼图和类内相关系数(ICC)验证其一致性。这种方法可根据∠CDH 将胎位分为过屈、中立和过伸。使用加权卡帕系数(k 值)评估了与 Ioannou、Wanyonyi 和 Roux 方法的比较准确性。结果 试验组包括 2186 张胎儿 CRL 图像,验证组包括 1193 张图像。测量的一致性很高(ICCs 为 0.993;PConclusion ∠CDH 方法已被验证为一种用于初产妇胎位评估的高度可重复性和准确性的技术。这为将来将其纳入智能评估模型奠定了基础。
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来源期刊
Ultrasound International Open
Ultrasound International Open RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
3.00
自引率
0.00%
发文量
7
审稿时长
12 weeks
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