Link: https://www.ncbi.nlm.nih.gov/pubmed/30244491

J Ultrasound Med. 2018 Sep 23. doi: 10.1002/jum.14826. [Epub ahead of print]
Reproducibility of Liver-to-Thorax Area Ratio Ultrasound Measurements in Congenital Diaphragmatic Hernia.
Novoa Y Novoa VA1, Sutton LF1, Neis AE1, Marroquin AM1, Coleman TM1, Praska KA1, Freimund TA1, Ruka KL1, Warzala VL1, Sangi-Haghpeykar H2, Ruano R1.
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Abstract
OBJECTIVES:
The aim of this study was to investigate the reproducibility of a standardized method to assess the ultrasound liver-to-thoracic area ratio in fetuses with congenital diaphragmatic hernia.

METHODS:
We selected 24 images of 9 fetuses diagnosed with left-sided at our institution between January 2010 and December 2017. Eight operators (1 maternal-fetal medicine specialist and 7 sonographers) reviewed the selected images and assessed the ultrasound liver-to-thoracic area ratio according to a standardized protocol. We evaluated the correlation between operators using the intraclass correlation coefficient and compared agreement between the sonographers and a physician with experience in measuring the ultrasound liver-to-thoracic area ratio using a Bland-Altman analysis.

RESULTS:
Good intraoperator reproducibility was observed for the standardized ultrasound liver-to-thoracic area ratio (intraclass correlation coefficient, 0.7. Good agreement among sonographers and the physician was also observed for the standardized measurements (bias, 0.01; precision, 0.03; limits of agreement, -0.05 to + 0.07).

CONCLUSIONS:
We demonstrated that good intraoperator and interoperator reproducibility of ultrasound liver-to-thoracic area ratio assessment is feasible after standardizing the method in our center.

© 2018 by the American Institute of Ultrasound in Medicine.

KEYWORDS:
congenital diaphragmatic hernia; fetal lungs; fetal therapy; fetoscopic tracheal occlusion; liver-to-thoracic area; obstetrics; prenatal diagnosis; pulmonary hypoplasia; ultrasound

PMID: 30244491 DOI: 10.1002/jum.14826