Objective To assess the feasibility of a specific training program for ultrasound diagnosis of adnexal masses. Methods
Objective: To assess the feasibility of identifying structures included in anterior complex (AC) and posterior complex (PC), as well as a series of anatomic landmarks that could help to demonstrate the integrity of the cerebral proximal hemisphere (PH).Methods: This was a prospective observational multicenter study of healthy pregnant women attending routine ultrasound screening at 20 + 0 to 33 + 6 weeks' gestation.Six physicians performed transabdominal (TA) ultrasound, in order to obtain the planes required to visualize the AC, PC, and PH. Blind analysis by a nonexpert and two experts in fetal neurosonography was used to assess the structures included in each plane view.Results: In the population studied (n = 747), detection of the structure rates for AC, PC, and proximal hemisphere was of 94%, 93%, and 96%, respectively, with an agreement of 97%, 94%, and 98% when comparing an expert and a nonexpert in fetal brain examiner. Detection of structures in the proximal hemisphere was significantly higher when observed through the proximal hemisphere plane rather than the transventricular plane.Conclusion: Our results suggest that inclusion of AC and PC complexes visualization, as well as real-time access to the proximal hemisphere, is feasible and could improve the prenatal detection of fetal cerebral anomalies.
<b><i>Objective:</i></b> To introduce visualization of the germinal matrix (GM), external angle of the frontal horn, and periventricular white matter while evaluating the anterior complex (AC) during basic ultrasound assessment of the fetal brain. <b><i>Case Presentations:</i></b> This is a retrospective observational study of healthy women with singleton pregnancies, with no increased risk of fetal central nervous system anomalies, attending routine ultrasound screening at 20–32 weeks’ gestation. Seventeen cases are presented in which an abnormal aspect of the GM or external angle of the frontal horn or periventricular white matter on AC evaluation has allowed a prenatal diagnosis of peri-intraventricular hemorrhage, subependymal cysts, connatal cysts, periventricular venous hemorrhagic infarction, and white matter injury. <b><i>Conclusion:</i></b> An extended AC evaluation could significantly improve the diagnosis of hemorrhagic/cystic/hypoxic-ischemic lesions during the performance of a basic ultrasound study of the fetal brain.
Objective To perform an external validation of Gynecological Imaging and Reporting Data System (GI-RADS) and to assess how referring clinicians value this reporting system in their daily practice. Materials and methods Prospective observational study comprising 257 women (mean age 40.3 years) and 281 adnexal masses, referred by 20 clinicians to an ultrasound referral center. All women underwent transvaginal or transrectal ultrasound. Presumed diagnosis of the adnexal mass was based on examiner's subjective impression according to patter recognition analysis. Reporting was performed according to GI-RADS classification. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) of the GI-RADS were calculated. The gold standard was histologic diagnosis (benign or malignant) or spontaneous resolution of the cyst during follow-up (benign). Referring clinicians were asked for completing a survey in order to assess how useful they considered this reporting system. Results In this study, 56 masses were classified as GI-RADS 2, 174 masses were classified as GI-RADS 3, 19 masses were classified as GI-RADS 4, and 32 masses were classified as GI-RADS 5. Among them, 230 masses were removed surgically and 51 masses resolved spontaneously. There were 35 malignant lesions. Sensitivity, specificity, LR+, and LR- were 97.1% (95% confidence interval (CI): 85.5–99.5%), 93.1% (95%CI: 89.2– 95.6%), 14.1 (95%CI: 8.8–22.3), and 0.03 (95%CI: 0.004–0.21) respectively. All 20 referring clinicians reported that GI-RADS was very useful for their clinical decision-making process. Conclusion GI-RADS shows a high diagnostic performance and is helpful for referring clinicians for taking clinical decisions. How to cite this article Diaz L, Zambrano B, Adami FJ, Alcázar JL. External Validation of Gynecological Imaging and Reporting Data System for Sonographic Evaluation of Adnexal Masses. Donald School J Ultrasound Obstet Gynecol 2017;11(2):135-140.
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