Comparison between 3-dimensional cranial ultrasonography and conventional 2-dimensional cranial ultrasonography in neonates: impact on reinterpretation

PURPOSE: The aim of this study was to evaluate impact of 3-dimensional cranial ultrasonography (3DUS) on reinterpretation of cranial ultrasonography images in neonates in comparison with 2-dimensional cranial ultrasonography (2DUS). METHODS: We retrospectively enrolled 50 young infants who simultaneously underwent both 2DUS and 3DUS scanning from February to March 2015. Two pediatric radiologists independently reviewed both scans for overall image quality on a 5-point scale. Five features were evaluated in both scans: the presence of germinal matrix hemorrhage (GMH), intraventricular hemorrhage (IVH), ventriculomegaly (VM), abnormality of periventricular echogenicity (PVE), and focal parenchymal lesions (FL). The concordance rate between the two scanning modes was calculated. The confidence level for each finding on a 3-point scale and the scanning time were compared between the two scanning modes. Interobserver agreement was evaluated using kappa statistics. RESULTS: Both scans demonstrated similar overall image quality in terms of reinterpretation (mean scores for 2DUS and 3DUS, 4.0±0.5 and 4.0±0.7 in reviewer 1, 3.9±0.6 and 4.0±0.8 in reviewer 2, respectively). GMH, IVH, VM, and FL showed perfect concordance, while PVE showed a concordance rate of 91.4% between the two modes by both reviewers. 3DUS was associated with a higher diagnostic confidence in the evaluation of GMH, IVH, and FL than 2DUS (P < 0.05) for both reviewers. For PVE, 3DUS received a significantly higher confidence score than 2DUS from one of the reviewers. The mean scanning time for 2DUS and 3DUS was 92.75 seconds and 36 seconds, respectively. Interobserver agreement for qualitative scoring was almost perfect. CONCLUSION: In reinterpretation, 3DUS showed very high concordance with 2DUS and a similar image quality. 3DUS also increased diagnostic confidence for several image findings and significantly decreased scan time.

The Interobserver Variability and Diagnostic Performance of 3-Dimensional Breast Ultrasound

PURPOSE: We wanted to evaluate the interobserver variability and diagnostic performance of 3-dimensional (3D) breast ultrasound (US) as compared with that of 2-dimensional (2D) US. MATERIALS AND METHODS: We included 150 patients who received US-guided core biopsy and 3D US between June 2009 and April 2010. Three breast imaging radiologists analyzed the 2D and 3D US images using the Breast Imaging Reporting and Data System (BI-RADS) lexicon. The intra-observer agreement and inter-observer agreement were calculated. The sensitivity and specificity of 2D and 3D US were evaluated. RESULTS: The intra-observer agreement between 2D and 3D US was mostly slight or fair agreement. However, in terms of the final category, there was substantial agreement for all three radiologists. The inter-observer agreement of 3D US was similar to that of 2D US (moderate agreement for shape, orientation, circumscribed margin and boundary; fair agreement for indistinct margin, angular margin, microlobulated margin, echo pattern and final category). The sensitivity of 3D US for breast cancer was higher than that of 2D US for two radiologists (2D vs. 3D for reader 2: 55.8% vs. 61.5%, 2D vs. 3D for reader 3: 59.6% vs. 63.5%), and the specificity of 3D US was lower than that of 2D US for all the readers (2D vs. 3D for reader 1: 90.8% vs. 86.7%, 2D vs. 3D for reader 2: 90.8% vs. 87.8%, 2D vs. 3D for reader 3: 94.9% vs. 90.8%), but the difference was not significant (p > or = 0.05). CONCLUSION: The interobserver variability and diagnostic performance of 3D breast US were similar to those of 2D US.

Initial Experience of 3-Dimensional Ultrasound Reconstruction of Carotid Artery

PURPOSE: The atherosclerotic plaque of carotid artery is associated with an increased risk of cerebral infarction. The aim of this study was to evaluate the feasibility and the clinical usefulness of 3-dimensional (3-D) reconstruction of carotid artery. METHODS: We performed conventional 2-D using 15 MHz transducer and 3-D ultrasound examinations of carotid arteries in 19 subjects (M:F=10:9, mean age=51+/-16 yrs, range 30-70yrs, 13 subjects with coronary artery disease, 6 normal volunteer). Ultrasound images were acquired with a 7.5 MHz linear array transducer (HP Sonos 5500) and a freehand acquisition kit. The 3-D reconstruction was performed with a specialized software (Tomtec). RESULTS: 1) The recorded images were easily reconstructed within about 90 seconds. 2) The reconstruction of 3-D images were obtained in 18 of 19 subjects (95%). 3) Of eighteen 3-D images of carotid arteries, 9 plaques were clearly visualized. 4) The locations of plaque of 3-D image were closely related with conventional 2-D images but hidden plaques were also detected. CONCLUSION: 3-D reconstruction of carotid artery is very feasible and provides additional and exact informations about the plaque morphology and location.