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Updated: May 19, 2026
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Photogrammetry: an accurate and reliable tool to detect thoracic musculoskeletal abnormalities in preterm infants
Josy Davidson1, Amelia Miyashiro N dos Santos, Kessey Maria B Garcia
1Department of Pediatrics-Neonatal Division of Medicine, Federal University of São Paulo, Rua Dr. Diogo de Faria 764, CEP 04037-002 São Paulo, SP, Brazil.
Insights
Photogrammetry accurately detects thoracic abnormalities in preterm infants. This reliable tool aids in identifying shoulder elevation and chest retractions, improving infant respiratory assessments.
Area of Science:
- Medical Imaging
- Pediatric Pulmonology
- Biomechanical Analysis
Background:
- Premature infants are susceptible to thoracic abnormalities.
- Accurate assessment of these abnormalities is crucial for timely intervention.
- Existing methods may have limitations in precision and reproducibility.
Purpose of the Study:
- To evaluate the accuracy and reproducibility of photogrammetry for detecting thoracic abnormalities in preterm infants.
- To assess the reliability of specific measurements, including the manubrium/acromion/trapezius angle and thoracic retraction.
- To validate a novel software tool (SAPO) for this purpose.
Main Methods:
- A cross-sectional study involving 58 preterm infants.
- Photogrammetric analysis of digitized photographs using the SAPO software.
- Independent physical examinations by two physiotherapists for comparison.
- Measurement of manubrium/acromion/trapezius angle and deepest thoracic retraction.
Main Results:
- Thoracic alterations were identified in 67% and 69% of infants by two physiotherapists, showing good agreement (kappa=0.80).
- Photogrammetry demonstrated high accuracy in detecting thoracic abnormalities, with area under the curve values of 0.79 for the angle and 0.91 for retraction.
- Excellent intra-rater and inter-rater reliability was observed for both angle and retraction measurements.
Conclusions:
- The SAPO software, utilizing photogrammetry, is an accurate and reliable tool for detecting thoracic abnormalities in preterm infants.
- This method offers a reproducible approach to assessing key parameters like shoulder elevation and thoracic retraction.
- Photogrammetry presents a promising non-invasive technique for monitoring respiratory health in this vulnerable population.
Objective:
To analyse the accuracy and reproducibility of photogrammetry in detecting thoracic abnormalities in infants born prematurely.
Design:
Cross-sectional study.
Setting:
The Premature Clinic at the Federal University of São Paolo.
Participants:
Fifty-eight infants born prematurely in their first year of life.
Outcome Measures:
Measurement of the manubrium/acromion/trapezius angle (degrees) and the deepest thoracic retraction (cm). Digitised photographs were analysed by two blinded physiotherapists using a computer program (SAPO; http://SAPO.incubadora.fapesp.br) to detect shoulder elevation and thoracic retraction. Physical examinations performed independently by two physiotherapists were used to assess the accuracy of the new tool.
Results:
Thoracic alterations were detected in 39 (67%) and in 40 (69%) infants by Physiotherapists 1 and 2, respectively (kappa coefficient=0.80). Using a receiver operating characteristic curve, measurement of the manubrium/acromion/trapezius angle and the deepest thoracic retraction indicated accuracy of 0.79 and 0.91, respectively. For measurement of the manubrium/acromion/trapezius angle, the Bland and Altman limits of agreement were -6.22 to 7.22° [mean difference (d)=0.5] for repeated measures by one physiotherapist, and -5.29 to 5.79° (d=0.75) between two physiotherapists. For thoracic retraction, the intra-rater limits of agreement were -0.14 to 0.18cm (d=0.02) and the inter-rater limits of agreement were -0.20 to -0.17cm (d=0.02).
Conclusion:
SAPO provided an accurate and reliable tool for the detection of thoracic abnormalities in preterm infants.
