- 14 de julio de 2025
Artículo de interés - Reproducibility of Breech Progression Angle: Standardization of Transperineal Measurements and Development of Image-Based Checklist for Quality Control
Ana M. Fidalgo, Adriana Aquise, Francisca S. Molina, Aly Youssef, Otilia González-Vanegas, Elena Brunelli, Ilaria Cataneo, Maria Segata, Marcos J. Cuerva, Valeria Rolle and Maria M. Gil
Diagnostics 2025. https://doi.org/10.3390/diagnostics15141757
Nuevo artículo de interés para la RICORS-SAMID
La publicación de este artículo liderado por el grupo dirigido por la Dra. M Mar Gil (RD24/0013/0018) contribuirá a aumentar la precisión diagnóstica en la presentación de nalgas.
RESUMEN
Objetivos
To evaluate the reproducibility of measurements of breech progression angle (BPA) by transperineal ultrasound (US) before and after its standardization by applying an image-based checklist
Métodos
Eighteen 3-dimensional (3D) volumes of transperineal US from women at 36–40 weeks of gestation with a singleton fetus in breech presentation were provided to eight operators from four maternity units in Spain and Italy. All operators measured the BPA using 3D US volume processing software, and interobserver reproducibility was evaluated using the intraclass correlation coefficient (ICC). Following an online live review of all measurements by the operators, and the identification of sources of disagreement, an image-based scoring system for BPA measurement was collaboratively developed. The checklist included the following: (1) acquisition in the midsagittal plane, avoiding the posterior shadow of the pubic ramus; (2) visualization of the complete “almond-shaped” pubic symphysis; (3) drawing a first line along the longitudinal axis of the symphysis, dividing it equally; (4) extending this line to the inferior edge of the bone; and (5) drawing a second line tangentially from the lower edge of the symphysis to the lowest recognizable fetal part. The BPA measurements were then repeated using this checklist, and reproducibility was reassessed.
Resultados
Eighteen volumes were analyzed by the eight operators, achieving a moderate reproducibility (ICC: 0.70, 95% confidence interval (CI): 0.48 to 0.86). A score was developed to include a series of landmarks for the appropriate assessment of BPA. Subsequently, the same eighteen volumes were reassessed using the new score, resulting in improved reproducibility (ICC: 0.81, 95% CI: 0.66 to 0.92).
Conclusiones
The measurement of BPA is feasible and reproducible when using a standardized image-based score.