Methods And Advantages Of Ultrasound Evaluation Of Fetal Hip Joint And Spleen

Objective To evaluate the feasibility of obtaining fetal hip joint by using ultrasonography(US) with high resolution ultrasound technique and establish normalreference intervals; and also evaluate the clinical significance and the impactfactors of the fetal hip development.Methods Measurements of the ilium length(R), acetabulum length(r), femoralhead diameter(D), α angle, β angle and morin ratio(MR) of fetal hip joint were performed on20fetuses by US. The intrauterine and extrauterine consistencyor the measurements were analyzed by Bland-Altman analysis, while intra-and inter-observer reproducibility by interclass correlation coefficient(ICC). A cross-sectional study was performed on normal singleton pregnancies(n=480) andon fetuses with hip joint and skeletal system malformations or abnormal amniotic fluid(n=48). The indicators of hip joint of all normal fetal (including R、r、D、 α、β、MR) were measured and the correlation between amniotic fluid,gender, fetal position and the hip developmental were analysed. Linear regression analysis was utilized to estimate the hip joint for each fetus, and quadraticregression analysis was used to assess the relationship between the hip joint and gestational age in the period from21to40weeks. The normal values of hip joint were plotted as a function of gestational age to establish a nomogram.Results The high degree of consistency(between intrauterine and extrauterine)and reproducibility(the intraclass correlation coefficient of intra-and inter-observer) were observed in measurement of the R(cm), r(cm), D(cm), α angle(°), β angle(°) and MR(%) of fetal hip joint by US. The regression formula were: ilium length(cm)=-2.445＋0.227GA－0.002GA2; acetabulum length(cm)=-0.881+0.079GA；femoral head diameter(cm)=-1.571+0.132GA-0.001GA2; α angle(°)=85.791-1.222GA+0.016GA2; β angle(°)=31.991+0.021GA+0.008GA2; MR(%)=79.173-0.7 06GA+0.003GA2(all P＜0.05). There were no significant differences in amnioticfluid, gender, fetal position between deformities of hip joint and skeletal system malformations group, different amniotic fluid group and controls (P＞0.05).Conclusion Fetal hip joint can be reproducibly measured by the high resolution ultrasound technique. It appears that fetal hip development can be assessedby high resolution ultrasound. Objective To investigate the method of detecting fetal spleen by using2D/3Dultrasound(US) and create a nomogram; to choose the best measurement indexto discover the abnormal spleen and evaluate its clinical significance.Methods A cross-sectional study was performed on normal singleton pregnancies(n=400).All fetuses were measured for fetal splenic size, including length,thickness, circumference and area, on transverse view of the fetal abdomen by2D US; for volume by3D US-VOCAL technology. Consistency for the measurements between in-utero and out-utero on20fetuses were analyzed by Bland-Altman analysis. Intra-and inter-observer reproducibility for the measurementson30fetuses which were selected randomly were analyzed by intra-class correlation coefficient. Quadratic regression analysis was used to assess the relationship between the spleen size and gestational age. The normal values of spleenwere plotted as a function of gestational age to create a normogram.Results A high degree of consistency and reproducibility was observed in measurement of the length(cm), thickness(cm),circumference(cm),area(cm2) and volume(cm3) of fetal spleen by US. The regression formula were: length(cm)=-0.334＋0.095GA＋0.095GA2；thickness(cm)=-0.747＋0.090GA；circumference(cm)=-1.745＋0.316GA＋0.001GA2；area(cm2)=2.98-0.307GA＋0.011GA2；volume(cm3)=8.142－0.774GA＋0.02GA2（all P＜0.001）. A total of6fetuses with splenomegaly and1splenic cyst were discovered.Conclusions Fetal spleen can be reproducibly measured by the high resolutionultrasound. Splenic volume is the best index to evaluate the splenic size.