Comparative Analysis of 2-D Versus 3-D ultrasound estimation of the fetal adrenal gland volume and prediction of preterm birth

Ozhan M. Turan, Sifa Turan, Irina A. Buhimschi, Edmund F. Funai, Katherine H. Campbell, Ozan M. Bahtiyar, Chris R. Harman, Joshua A. Copel, Ahmet A. Baschat, Catalin S. Buhimschi

Research output: Contribution to journalArticlepeer-review

Abstract

ObjectiveWe aim to test the hypothesis that two-dimensional (2-D) fetal adrenal gland volume (AGV) measurements offer similar volume estimates as volume calculations based on 3-D technique. MethodsFetal AGV was estimated by three-dimensional (3-D) ultrasound (VOCAL) in 93 women with signs/symptoms of preterm labor and 73 controls. Fetal AGV was calculated using an ellipsoid formula derived from 2-D measurements of the same blocks (0. 523×length×width×depth). Comparisons were performed by intraclass correlation coefficient (ICC), coefficient of repeatability, and Bland-Altman method. The corrected AGV (cAGV; AGV/fetal weight) was calculated for both methods and compared for prediction of preterm birth (PTB) within 7 days. ResultsAmong 168 volumes, there was a significant correlation between 3-D and 2-D methods (ICC=0.979; 95% confidence interval [CI]: 0.971 to 0.984). The coefficient of repeatability for the 3-D was superior to the 2-D method (intraobserver 3-D: 30.8, 2-D:57.6; interobserver 3-D:12.2, 2-D: 15.6). Based on 2-D calculations, cAGV433 mm3/kg was best for prediction of PTB (sensitivity: 75%, 95% CI=59 to 87; specificity: 89%, 95% CI=82 to 94). Sensitivity and specificity for the 3-D cAGV (cutoff420 mm3/kg) was 85% (95% CI=70 to 94) and 95% (95% CI=90 to 98), respectively. In receiver-operating-curve curve analysis, 3-D cAGV was superior to 2-D cAGV for prediction of PTB (z=1.99, p=0.047). Conclusion2-D volume estimation of fetal adrenal gland using ellipsoid formula cannot replace 3-D AGV calculations for prediction of PTB.

Original languageEnglish (US)
Pages (from-to)673-679
Number of pages7
JournalAmerican journal of perinatology
Volume29
Issue number9
DOIs
StatePublished - 2012
Externally publishedYes

Keywords

  • 3-D ultrasound
  • fetal adrenal gland
  • preterm birth
  • volume measurement

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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