Reference range of embryo volume by 3-D sonography using the XI VOCAL method at 7 to 10 + 6 weeks of pregnancy.

We sought to establish normative data for three-dimensional ultrasound (3DUS) first-trimester embryonic volume using the extended imaging virtual organ computer-aided analysis (XI VOCAL) technique. This cross-sectional study involved 64 normal pregnancies at 7 to 10 + 6 weeks' gestation. Embryonic volume was obtained on 3DUS using the XI VOCAL technique with manual outline of 10 sequential planes. The mean, median, standard deviation, and maximum and minimum values were obtained for each week calculated. Polynomial regression models adjusted by the determination coefficient (R(2)) were created to assess the correlation between embryonic volume and gestational age (GA) and crown rump length (CRL). The intraclass correlation coefficient (ICC) was used to calculate inter- and intraobserver reproducibility. Mean embryonic volume went from 0.20 cm(3) (range 0.10 to 0.89 cm(3)) to 5.12 cm(3) (range 2.90 to 5.98 cm(3)). Embryonic volume was strongly correlated with GA (R(2) = 0.84) and with CRL (R(2) = 0.87). There was a good inter- and intraobserver reproducibility of embryonic volume with ICC = 0.999 and 0.995, respectively. Reference range for 3DUS first-trimester embryonic volume using the XI VOCAL technique were generated for pregnancies at 7 to 10 + 6 weeks, with high inter- and intraobserver reproducibility.

Comparison of gestational sac volume by 3D-sonography using planimetric, virtual organ computer-aided analysis and extended imaging virtual organ computer-aided analysis methods between 7 and 11 weeks of pregnancy.

OBJECTIVE: To compare different three-dimensional (3D) methods in the assessment of gestational sac volume (GSV). DESIGN: Cross-sectional study involving 74 normal pregnancies between 7 and 11 weeks. SETTING: Department of Obstetrics, São Paulo Federal University (UNIFESP). METHODS: GSV was measured through 3D ultrasound using the planimetric, virtual organ computer-aided analysis (VOCAL) and extended imaging virtual organ computer-aided analysis (XI VOCAL) methods. The planimetric method used a sequence of adjacent planes that are 3 mm thick. For the VOCAL methods, six adjacent planes and a 30 degrees rotation were used. A total of 15 adjacent planes were used for the XI VOCAL method. Regression models with a determination coefficient (R(2)) were created to assess the correlation between GSV and gestational age (GA). Intraclass correlation coefficient (ICC) and Bland-Altman graphs were used to assess the correlation between the three methods and ANOVA was used to compare means. RESULTS: All three methods showed a correlation between GSV and GA (R(2) = 0.65 for XI VOCAL, R(2) = 0.65 for planimetric and R(2) = 0.66 for VOCAL). There was a strong correlation between the three methods (XI VOCAL vs. planimetric ICC = 0.995; XI VOCAL vs. VOCAL ICC = 0.998 and planimetric vs. VOCAL ICC = 0.995) without any significant differences according to the Bland-Altman graphs or ANOVA (p < 0.002). CONCLUSIONS: The three 3D ultrasound methods used for GSV assessment between 7 and 11 weeks are concordant. These methods can be used interchangeably during the first trimester of pregnancy to measure GSV.

Embryo vascularization by three-dimensional power Doppler ultrasonography at 7-10 weeks of pregnancy.

AIM: Assess vascular indices of 7-10 week embryos using three-dimensional power Doppler (3DPD) and correlate them with the crown-rump length (CRL). METHODS: This cross-sectional study included 65 healthy pregnancies between 7 and 10 weeks. The three-dimensional volume of the embryo was obtained using an endocavitary volumetric transducer and the VOCAL (Virtual Organ Computer-aided Analysis) method, with a 12 degree rotation angle and 15 sequential planes. The vascularization (VI), flow (FI) and the vascular and flow (VFI) indices were obtained using 3DPD and the mean, median, standard deviation, maximum and minimum values were calculated for each gestational age. Pearson's correlation coefficient (r) was used to evaluate the correlation between vascular indices and CRL. RESULTS: The VI ranged from 0.77 to 41.67, mean 14.68 (+/-8.60), the FI went from 25.71 to 139.50, mean 90.61 (+/-21.51) and the VFI from 0.20 to 81.57, mean 15.69 (+/-12.42). The correlation between CRL and all 3D power Doppler vascular indices was low (VI - r=-0.073, P=0.566; FI - r=0.173, P=0.168 and VFI - r=-0.004, P=0.974). CONCLUSION: 3D power Doppler vascular indices in 7-10 week embryos do not correlate with CRL.

[Embryo volume estimated by three-dimensional ultrasonography at seven to ten weeks of pregnancy]. / Volume do embrião estimado pela ultra-sonografia tridimensional entre a sétima e a décima semana de gestação.

PURPOSE: to evaluate the embryo's volume (EV) between the seventh and the tenth gestational week, through tridimensional ultrasonography. METHODS: a transversal study with 63 normal pregnant women between the seventh and the tenth gestational week. The ultrasonographical exams have been performed with a volumetric abdominal transducer. Virtual Organ Computer-aided Analysis (VOCAL) has been used to calculate EV, with a rotation angle of 12 masculine and a delimitation of 15 sequential slides. The average, median, standard deviation and maximum and minimum values have been calculated for the EV in all the gestational ages. A dispersion graphic has been drawn to assess the correlation between EV and the craniogluteal length (CGL), the adjustment being done by the determination coefficient (R(2)). To determine EV's reference intervals as a function of the CGL, the following formula was used: percentile=EV+K versus SD, with K=1.96. RESULTS: CGL has varied from 9.0 to 39.7 mm, with an average of 23.9 mm (+/-7.9 mm), while EV has varied from 0.1 to 7.6 cm(3), with an average of 2.7 cm(3) (+/-3.2 cm(3)). EV was highly correlated to CGL, the best adjustment being obtained with quadratic regression (EV=0.2-0.055 versus CGL+0.005 versus CGL(2); R(2)=0.8). The average EV has varied from 0.1 (-0.3 to 0.5 cm(3)) to 6.7 cm(3) (3.8 to 9.7 cm(3)) within the interval of 9 to 40 mm of CGL. EV has increased 67 times in this interval, while CGL, only 4.4 times. CONCLUSIONS: EV is a more sensitive parameter than CGL to evaluate embryo growth between the seventh and the tenth week of gestation.