TY - JOUR
T1 - Comparison of conventional versus three-dimensional ultrasound in fetal renal pelvis measurement and their potential prediction of neonatal uropathies
AU - Duin, L. K.
AU - Nijhuis, J. G.
AU - Scherjon, S. A.
AU - Vossen, M.
AU - Willekes, C.
PY - 2016
Y1 - 2016
N2 - Objective: To establish a threshold value for fetal renal pelvis dilatation measured by automatic volume calculation (SonoAVC) in the third trimester of pregnancy to predict neonatal uropathies, and to compare these results with conventional antero-posterior (AP) measurement, fetal kidney 3D volume and renal parenchymal thickness.Methods: In a prospective cohort study, 125 fetuses with renal pelvis AP diameter of 5mm both at 20 weeks of gestation and in the third trimester, underwent an additional 3D volume measurement of the fetal kidney in the third trimester. Receiver operating characteristic (ROC) curves for establishing threshold values for fetal renal pelvis volume, AP measurement, fetal kidney volume and renal parenchymal thickness to predict neonatal uropathies were analyzed. Also, sensitivity, specificity, area under the curve (AUC) and likelihood ratios were calculated.Results: A cut-off point of 1.58cm(3) was identified in the third trimester of pregnancy (AUC 0.865 (95% CI 0.789-0.940), sensitivity 76.3%, specificity 87.4%, LR+6.06, LR-0.27) for measurements with SonoAVC. A cut-off value of 11.5mm was established in the third trimester of pregnancy (AUC 0.828 (95% CI 0.737-0.918), sensitivity 71.1%, specificity 85.1%, LR+4.77, LR-0.34) for the conventional AP measurement. A cut-off point for fetal kidney volume was calculated at 13.29cm(3) (AUC 0.769 (95% CI 0.657-0.881), sensitivity 71%, specificity 66%, LR+2.09, LR-0.44). For renal parenchymal thickness, a cut-off point of 8.4mm was established (AUC 0.216 (95% CI 0.117-0.315), sensitivity 31.6%, specificity 32.6%, LR+0.47, LR-2.10).Conclusion: This study demonstrates that 3D fetal renal pelvis volume measurements and AP measurements both have a good and comparable diagnostic performance, fetal renal volume a fair accuracy and renal parenchymal thickness a poor accuracy in predicting postnatal renal outcome.
AB - Objective: To establish a threshold value for fetal renal pelvis dilatation measured by automatic volume calculation (SonoAVC) in the third trimester of pregnancy to predict neonatal uropathies, and to compare these results with conventional antero-posterior (AP) measurement, fetal kidney 3D volume and renal parenchymal thickness.Methods: In a prospective cohort study, 125 fetuses with renal pelvis AP diameter of 5mm both at 20 weeks of gestation and in the third trimester, underwent an additional 3D volume measurement of the fetal kidney in the third trimester. Receiver operating characteristic (ROC) curves for establishing threshold values for fetal renal pelvis volume, AP measurement, fetal kidney volume and renal parenchymal thickness to predict neonatal uropathies were analyzed. Also, sensitivity, specificity, area under the curve (AUC) and likelihood ratios were calculated.Results: A cut-off point of 1.58cm(3) was identified in the third trimester of pregnancy (AUC 0.865 (95% CI 0.789-0.940), sensitivity 76.3%, specificity 87.4%, LR+6.06, LR-0.27) for measurements with SonoAVC. A cut-off value of 11.5mm was established in the third trimester of pregnancy (AUC 0.828 (95% CI 0.737-0.918), sensitivity 71.1%, specificity 85.1%, LR+4.77, LR-0.34) for the conventional AP measurement. A cut-off point for fetal kidney volume was calculated at 13.29cm(3) (AUC 0.769 (95% CI 0.657-0.881), sensitivity 71%, specificity 66%, LR+2.09, LR-0.44). For renal parenchymal thickness, a cut-off point of 8.4mm was established (AUC 0.216 (95% CI 0.117-0.315), sensitivity 31.6%, specificity 32.6%, LR+0.47, LR-2.10).Conclusion: This study demonstrates that 3D fetal renal pelvis volume measurements and AP measurements both have a good and comparable diagnostic performance, fetal renal volume a fair accuracy and renal parenchymal thickness a poor accuracy in predicting postnatal renal outcome.
KW - Fetal renal pelvis
KW - hydronephrosis
KW - pyelectasis
KW - SonoAVC
U2 - 10.3109/14767058.2015.1090970
DO - 10.3109/14767058.2015.1090970
M3 - Article
SN - 1476-7058
VL - 29
SP - 2493
EP - 2498
JO - Journal of Maternal-Fetal & Neonatal Medicine
JF - Journal of Maternal-Fetal & Neonatal Medicine
IS - 15
ER -