Inter-and intra-observer consistency in obtaining key views of fetal echocardiography by Smart-Planes Fetal Heart: a preliminary study

doi:10.3877/cma.j.issn.1672-6448.2020.06.008

Abstract

Abstract:

Objective

To explore the inter- and intra-observer consistency in the acquisition of important sections of fetal echocardiography by Smart-Planes Fetal Heart (S-Planes FH).

Methods

An experienced fetal echocardiographer (doctor A) used three-dimensional volume probe to collect three to five three-dimensional volume date sets of the fetal heart based on four chamber views from 58 normal single fetuses in second and third trimesters. Three doctors with different experiences (doctor A, doctor B, and doctor C) independently analyzed the images after offline processing by S-planes FH at different times, and scored the diagnostic elements displayed in each section. Doctor B scored the processed image twice. The success rate of all diagnostic sections of the three doctors was obtained, and the mean value of each diagnostic section element score was calculated to analyze the display success rate of all diagnostic sections of the three doctors, calculate the scores of diagnostic elements of each section, and to analyze the consistency and difference between and within the observers.

Results

In 58 normal fetuses, 241 volume data sets were obtained. After doctors A, B, and C applied S-planes FH technology to deal with volume data, respectively, the rates of successful display of all six important sections were 71.34% (172/241), 70.12% (169/241), and 72.20% (174/241). There was no significant difference between doctors B and C (P=0.649) and between doctors B and A (P=0.804). The scores obtained by the three doctors with different experiences on six important sections were in good agreement, with an intraclass correlation coefficient (ICC)>0.75. There was no significant difference between doctor B and experienced doctor C or expert doctor A (P=0.05). Doctor B had a good consistency in the scores of diagnostic factors at two different times, and the ICC was more than 0.75. There was no significant difference between the two scores obtained by doctor B (P>0.05).

Conclusion

S-planes FH technology is easy to operate and master for beginners, especially for inexperienced doctors, and it can improve the operator dependence in the acquisition of important sections of fetal echocardiography, and the consistency between and within the observers is good.

Key words: Echocardiography, Fetus, Heart defects, congenital, Intelligent navigation

Shuyi Lyu, Bowen Zhao, Yan Zhang, Mei Pan, Bei Wang, Xiaohui Peng, Ran Chen. Inter-and intra-observer consistency in obtaining key views of fetal echocardiography by Smart-Planes Fetal Heart: a preliminary study[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(06): 528-534.

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Figures/Tables 7

References 18

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不同医师	诊断切面显示成功率［个（%）］
不同医师	6个切面	胃泡切面	四腔心切面	左心室流出道切面	右心室流出道切面	动脉导管弓切面	三血管切面
医师A	172/241（71.34）	233/241（96.68）	226/241（93.78）	204/241（84.65）	187/241（77.59）	182/241（75.52）	195/241（80.91）
医师B	169/241（70.12）^a	231/241（95.85）^a	226/241（93.78）^a	207/241（85.89）^a	185/241（76.76）^a	180/241（74.69）^a	196/241（81.33）^a
医师C	174/241（72.20）^b	231/241（95.85）^b	225/241（93.36）^b	210/241（87.14）^b	191/241（79.25）^b	177/241（73.44）^b	192/241（79.67）^b

不同医师	诊断切面显示成功率［个（%）］
不同医师	6个切面	胃泡切面	四腔心切面	左心室流出道切面	右心室流出道切面	动脉导管弓切面	三血管切面
医师A	172/241（71.34）	233/241（96.68）	226/241（93.78）	204/241（84.65）	187/241（77.59）	182/241（75.52）	195/241（80.91）
医师B	169/241（70.12）^a	231/241（95.85）^a	226/241（93.78）^a	207/241（85.89）^a	185/241（76.76）^a	180/241（74.69）^a	196/241（81.33）^a
医师C	174/241（72.20）^b	231/241（95.85）^b	225/241（93.36）^b	210/241（87.14）^b	191/241（79.25）^b	177/241（73.44）^b	192/241（79.67）^b

诊断切面	不同经验医师评分结果一致性检验
诊断切面	ICC	95%CI
胃泡切面	0.876	0.846~0.901
四腔心切面	0.804	0.757~0.843
左心室流出道切面	0.815	0.771~0.852
右心室流出道切面	0.876	0.876~0.901
动脉导管弓切面	0.931	0.915~0.945
三血管切面	0.758	0.700~0.806

诊断切面	不同经验医师评分结果一致性检验
诊断切面	ICC	95%CI
胃泡切面	0.876	0.846~0.901
四腔心切面	0.804	0.757~0.843
左心室流出道切面	0.815	0.771~0.852
右心室流出道切面	0.876	0.876~0.901
动脉导管弓切面	0.931	0.915~0.945
三血管切面	0.758	0.700~0.806

不同医师	各诊断切面评分结果（分）
不同医师	胃泡切面	四腔心切面	左心室流出道切面	右心室流出道切面	动脉导管弓切面	三血管切面
医师A	3.000（2.500，3.000）	2.750（2.625，3.000）	2.667（2.333，3.000）	2.000（2.000，2.750）	2.000（2.000，2.333）	2.333（2.000，3.000）
医师B	3.000（2.500，3.000）	2.750（2.625，3.000）	2.667（2.333，3.000）	2.225（2.000，2.750）	2.000（1.667，2.333）	2.333（2.000，3.000）
医师C	3.000（2.250，3.000）	2.750（2.625，3.000）	2.667（2.333，3.000）	2.225（2.000，2.750）	2.000（1.667，2.333）	2.333（2.000，3.000）

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