论文部分内容阅读
目的:对孕中期胎儿超声结构筛查进行了图像评分和cumulative sum(CUSUM)曲线联合质量控制法,以提高超声培训中胎儿结构筛查的准确性。方法:选取胎儿中枢神经系统、心脏、消化系统等标准切面,共28幅图象,要求每位参加超声培训超声医生扫查100例孕中期胎儿,采集各个切面并存储图像;由两位上级医师评估每幅图像的标准程度并予以评分,将评分值与总分值进行CUSUM分析,将每位超声医生评分的失败率设定为10%。用组内差异性分析(ICC)分别对两位评估医生和第一位评估医生进行自身差异性分析。结果:超声医生1、2和3图象234分(90%)以上均在80幅以上;评分医生A1、A2与评分医生B评分之间的ICC分别是0.985和0.977;评分医生A1与评分医生A2之间的ICC是0.992。评分医生A对三位超声医生评分的CUSUM曲线显示了三位超声医生分别在筛查74、89和61次后筛查能力合格。结论:胎儿结构筛查图象评分及CUSUM曲线联合质量控制法,有效地提高了超声培训中超声医生产前结构筛查的质量,认证了其独立筛查能力。
OBJECTIVE: To improve the accuracy of fetus structure screening in ultrasound training by performing image quality assessment and cumulative sum (CUSUM) curve combined with quality control in the second trimester fetal ultrasound structural screening. METHODS: A total of 28 images of fetal central nervous system (CNS), heart and digestive system were selected. Each ultrasound participant was asked to scan 100 fetuses of second trimester fetuses and collect all the sections and store the images. Two senior doctors The standard degree of each image was evaluated and scored. The score and total score were analyzed by CUSUM, and the failure rate of each ultrasound doctor was set as 10%. In-group variability analysis (ICC) conducted a self-analysis of the differences between the two assessors and the first assessor, respectively. Results: The scores of 1, 2 and 3 ultrasound were more than 80 in 234 (90%) and 0.985 and 0.977, respectively; the scores of doctors A1 and A2 and the score of doctor B were respectively 0.985 and 0.977; The ICC between A2 is 0.992. The CUSUM curve, which Scoring Doctor A scored on three ultrasound doctors, showed that three ultrasound physicians were eligible for screening after screening for 74, 89 and 61, respectively. Conclusion: Fetal structure screening image score and CUSUM curve combined with quality control method effectively improve the quality of ultrasound screening of prenatal screening by ultrasound doctors and validate its independent screening ability.