How true is a 'true' midsagittal section?

Area of Science:

• Medical Imaging
• Obstetrics and Gynecology
• Fetal Medicine

Background:

• Accurate midsagittal plane imaging is crucial for fetal biometry.
• The Fetal Medicine Foundation (FMF) certification aims to standardize ultrasound practices.
• The impact of sonographer certification on imaging accuracy and subsequent measurements requires investigation.

Purpose of the Study:

• To quantify the deviation of presumed midsagittal fetal head sections from the true plane.
• To compare imaging accuracy between FMF-certified and non-certified sonographers.
• To assess the influence of imaging plane deviation on nuchal translucency (NT) measurements.

Main Methods:

• Eight sonographers (4 FMF-certified, 4 non-certified) obtained midsagittal fetal head/neck images.
• Three-dimensional ultrasound datasets were analyzed.
• The angle between the falx cerebri and vertical axis was measured to assess deviation; its effect on NT was evaluated.

Main Results:

• FMF-certified sonographers showed significantly less deviation (mean 5.7° vs. 14.7°).
• NT underestimation by certified sonographers was not significant (1.8%).
• Non-certified sonographers could not measure NT at greater deviation angles (14.7°).

Conclusions:

• FMF certification leads to superior midsagittal plane acquisition in fetal ultrasound.
• Minor deviations by certified operators do not significantly impact NT measurements.
• The findings support FMF certification as a model for operator training and quality assurance.