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Publico-12552e.pdf: 1027770 bytes, checksum: 1018ee99b0a636ed92607fc88e71fba4 (MD5) / Objetivos: Validação in vitro do método XI VOCALTM (eXtended Imaging Virtual Organ Computer-Aided anaLysis TM) de volumetria ultrassonográfica tridimensional; construção de intervalos de referência para volume cardíaco fetal entre 20 e 34 semanas de gestação; avaliação da reprodutibilidade intra e interobservador. Pacientes e métodos: Foram confeccionados três diferentes “modelos” para validação in vitro. Os “modelos” foram mensurados por dois diferentes observadores, com os métodos XI VOCALTM, VOCALTM (Virtual Organ Computer-Aided anaLysis TM) e Multiplanar. A validade foi determinada comparando-se a porcentagem de diferença entre o volume calculado e o ‘real’. Para construção dos intervalos de referência para volume cardíaco procedeu-se um estudo transversal, avaliando 303 gestantes normais entre 20 e 34 semanas. Realizou-se uma única avaliação com método XI VOCALTM em 10 planos. Resultados: Todos os métodos apresentaram boa confiabilidade na volumetria dos “modelos”, quando comparados ao volume “real”. Não houve diferença estatística entre os métodos, entretanto as mensurações pelo XI VOCALTM, em 10 planos, apresentaram menor margem de erro (diferença média de 0,18cm³), sem comprometimento do tempo de exame. A avaliação cardíaca fetal permitiu a construção de um modelo de regressão linear ponderada, demonstrado maior variabilidade volumétrica com a progressão da idade gestacional. Com base na distribuição formataram-se os percentis 5, 10, 25, 50, 75, 90 e 95. Na análise da variabilidade intra e interobservador não houve diferença estatisticamente significante (p= 0,041 e p= 0,175, respectivamente), com alta reprodutibilidade (CCI >0,95). Conclusões: O método XI VOCALTM apresenta boa acurácia, principalmente em 10 planos, de acordo com os achados in vitro. O método demonstrou boa reprodutibilidade in vitro e in vivo. O volume cardíaco fetal demonstrou uma curva de ascenção ponderada entre 20 e 34 semanas de gestação. / Objectives: Validating an in vitro method for XI VOCALTM (eXtended Imaging Virtual Organ Computer-Aided anaLysys) three-dimensional ultrasound study; establishing intervals of reference to evaluate fetal heart volume between 20 and 34 gestational weeks; assessing the intraobserver and interobserver reproducibility for this method. Methods: In order to validate an in vitro method, three plastic models filled with ultrasound gel were constructed. These models were measured by two different observers using three different scan methods: XI VOCALTM, VOCALTM and Multiplanar. In order to achieve a reference curve with normal values of fetal heart volume, a cross-sectional study including 303 pregnant women between 20 and 34 gestational weeks was evaluated. The assessment was performed using a 10 plane section for each case. Results: All methods had high reliability and were considered useful for in vitro studies. There was no difference between the methods, although the evaluation using XI VOCALTM closer to the real volume of the models (mean difference 0,18 cm ³). The fetal heart evaluation allowed the construction of a polynomial regression model, with increasing of variability according to gestational age progression. The intervals of reference were calculated according to the percentiles 5, 10, 25, 50, 75, 90 and 95. There was no difference regarding the results achieved intra or inter observers (p = 0.041 and p = 0.175, respectively). The reproducibility of the method was considered good (ICC> 0.90). Conclusions: The XI VOCALTM method can be used for in vitro evaluation, with good accuracy, mainly with 10 planes section. This method has good reproducibility in clinical practice. The fetal heart volume has a rising curve between 20 and 34 gestational weeks. / TEDE
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unifesp.br:11600/9134 |
| Date | 27 April 2011 |
| Creators | Barreto, Enoch Quinderé de Sá [UNIFESP] |
| Contributors | Universidade Federal de São Paulo (UNIFESP), Moron, Antonio Fernandes [UNIFESP] |
| Publisher | Universidade Federal de São Paulo (UNIFESP) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UNIFESP, instname:Universidade Federal de São Paulo, instacron:UNIFESP |
| Rights | info:eu-repo/semantics/openAccess |
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