Maurice, P; Dhombres, F; Blondiaux, E; Friszer, S; Guilbaud, L; Lelong, N; Khoshnood, B; Charlet, J; Perrot, N; Jauniaux, E; Jurkovic, D; Jouannic, J-M
In: J Gynecol Obstet Hum Reprod, vol. 46, no. 5, pp. 423–429, 2017, ISSN: 2468-7847.
@article{pmid28934086,
title = {Towards ontology-based decision support systems for complex ultrasound diagnosis in obstetrics and gynecology},
author = {P Maurice and F Dhombres and E Blondiaux and S Friszer and L Guilbaud and N Lelong and B Khoshnood and J Charlet and N Perrot and E Jauniaux and D Jurkovic and J-M Jouannic},
doi = {10.1016/j.jogoh.2017.03.004},
issn = {2468-7847},
year = {2017},
date = {2017-05-01},
journal = {J Gynecol Obstet Hum Reprod},
volume = {46},
number = {5},
pages = {423--429},
abstract = {INTRODUCTION: We have developed a new knowledge base intelligent system for obstetrics and gynecology ultrasound imaging, based on an ontology and a reference image collection. This study evaluates the new system to support accurate annotations of ultrasound images. We have used the early ultrasound diagnosis of ectopic pregnancies as a model clinical issue.nnMATERIAL AND METHODS: The ectopic pregnancy ontology was derived from medical texts (4260 ultrasound reports of ectopic pregnancy from a specialist center in the UK and 2795 Pubmed abstracts indexed with the MeSH term "Pregnancy, Ectopic") and the reference image collection was built on a selection from 106 publications. We conducted a retrospective analysis of the signs in 35 scans of ectopic pregnancy by six observers using the new system.nnRESULTS: The resulting ectopic pregnancy ontology consisted of 1395 terms, and 80 images were collected for the reference collection. The observers used the knowledge base intelligent system to provide a total of 1486 sign annotations. The precision, recall and F-measure for the annotations were 0.83, 0.62 and 0.71, respectively. The global proportion of agreement was 40.35% 95% CI [38.64-42.05].nnDISCUSSION: The ontology-based intelligent system provides accurate annotations of ultrasound images and suggests that it may benefit non-expert operators. The precision rate is appropriate for accurate input of a computer-based clinical decision support and could be used to support medical imaging diagnosis of complex conditions in obstetrics and gynecology.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: We have developed a new knowledge base intelligent system for obstetrics and gynecology ultrasound imaging, based on an ontology and a reference image collection. This study evaluates the new system to support accurate annotations of ultrasound images. We have used the early ultrasound diagnosis of ectopic pregnancies as a model clinical issue.nnMATERIAL AND METHODS: The ectopic pregnancy ontology was derived from medical texts (4260 ultrasound reports of ectopic pregnancy from a specialist center in the UK and 2795 Pubmed abstracts indexed with the MeSH term “Pregnancy, Ectopic”) and the reference image collection was built on a selection from 106 publications. We conducted a retrospective analysis of the signs in 35 scans of ectopic pregnancy by six observers using the new system.nnRESULTS: The resulting ectopic pregnancy ontology consisted of 1395 terms, and 80 images were collected for the reference collection. The observers used the knowledge base intelligent system to provide a total of 1486 sign annotations. The precision, recall and F-measure for the annotations were 0.83, 0.62 and 0.71, respectively. The global proportion of agreement was 40.35% 95% CI [38.64-42.05].nnDISCUSSION: The ontology-based intelligent system provides accurate annotations of ultrasound images and suggests that it may benefit non-expert operators. The precision rate is appropriate for accurate input of a computer-based clinical decision support and could be used to support medical imaging diagnosis of complex conditions in obstetrics and gynecology.
Rouissi, Jihane; Arvieu, Robin; Dubory, Arnaud; Vergari, Claudio; Bachy, Manon; Vialle, Raphaël
In: Childs Nerv Syst, vol. 33, no. 2, pp. 337–341, 2017, ISSN: 1433-0350.
@article{pmid28028597,
title = {Intra and inter-observer reliability of determining degree of pelvic obliquity in neuromuscular scoliosis using the EOS-CHAIR® protocol},
author = {Jihane Rouissi and Robin Arvieu and Arnaud Dubory and Claudio Vergari and Manon Bachy and Raphaël Vialle},
doi = {10.1007/s00381-016-3326-5},
issn = {1433-0350},
year = {2017},
date = {2017-02-01},
journal = {Childs Nerv Syst},
volume = {33},
number = {2},
pages = {337--341},
abstract = {PURPOSE: Scoliosis with pelvic obliquity (PO) could be investigated with the EOS-CHAIR protocol as the most common deformity especially in patients with trunk hypotonia and quadriplegia. However, the intra-observer and inter-observer reliability of various angles assessing PO was not investigated with this new imaging protocol.nnMETHODS: A retrospective cohort of 36 EOS frontal full-spine acquisitions made in sitting position was used. The sacroiliac pelvic obliquity angle, iliac crest pelvic obliquity angle, and ischiatic pelvic obliquity angle were assessed in an intra-observer and inter-observer study.nnRESULTS: The use of the EOS-CHAIR protocol was implemented satisfactory with a high acceptance rate by all caregivers and patients and their families. Intra-observer and inter-observer reliability was excellent for the three tested angular measurements.nnDISCUSSION: As for idiopathic scoliosis, we postulate the EOS system as being superior to standard radiographs to assess 3D spinal deformities in neuromuscular conditions. The EOS-CHAIR protocol improves preoperative comprehension of the lumbosacral junction anatomy in patients with poor standing or sitting postures. Our results show a very high reliability of three different angular measurements of the frontal pelvic obliquity in sitting position. Then it is possible to use one of these three angles as well as the others to assess frontal pelvic obliquity in neuromuscular patients. This frontal pelvic obliquity protocol in sitting position with the EOS-CHAIR is a validated measurement technique that needs to be used now to measure PO as a critical parameter of the global trunk balance in neuromuscular patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: Scoliosis with pelvic obliquity (PO) could be investigated with the EOS-CHAIR protocol as the most common deformity especially in patients with trunk hypotonia and quadriplegia. However, the intra-observer and inter-observer reliability of various angles assessing PO was not investigated with this new imaging protocol.nnMETHODS: A retrospective cohort of 36 EOS frontal full-spine acquisitions made in sitting position was used. The sacroiliac pelvic obliquity angle, iliac crest pelvic obliquity angle, and ischiatic pelvic obliquity angle were assessed in an intra-observer and inter-observer study.nnRESULTS: The use of the EOS-CHAIR protocol was implemented satisfactory with a high acceptance rate by all caregivers and patients and their families. Intra-observer and inter-observer reliability was excellent for the three tested angular measurements.nnDISCUSSION: As for idiopathic scoliosis, we postulate the EOS system as being superior to standard radiographs to assess 3D spinal deformities in neuromuscular conditions. The EOS-CHAIR protocol improves preoperative comprehension of the lumbosacral junction anatomy in patients with poor standing or sitting postures. Our results show a very high reliability of three different angular measurements of the frontal pelvic obliquity in sitting position. Then it is possible to use one of these three angles as well as the others to assess frontal pelvic obliquity in neuromuscular patients. This frontal pelvic obliquity protocol in sitting position with the EOS-CHAIR is a validated measurement technique that needs to be used now to measure PO as a critical parameter of the global trunk balance in neuromuscular patients.
Limited Dorsal Myeloschisis: A Diagnostic Pitfall in the Prenatal Ultrasound of Fetal Dysraphism
Friszer, Stéphanie; Dhombres, Ferdinand; Morel, Baptiste; Zerah, Michel; Jouannic, Jean-Marie; Garel, Catherine
In: Fetal Diagn Ther, vol. 41, no. 2, pp. 136–144, 2017, ISSN: 1421-9964.
@article{pmid27160821,
title = {Limited Dorsal Myeloschisis: A Diagnostic Pitfall in the Prenatal Ultrasound of Fetal Dysraphism},
author = {Stéphanie Friszer and Ferdinand Dhombres and Baptiste Morel and Michel Zerah and Jean-Marie Jouannic and Catherine Garel},
doi = {10.1159/000445995},
issn = {1421-9964},
year = {2017},
date = {2017-01-01},
journal = {Fetal Diagn Ther},
volume = {41},
number = {2},
pages = {136--144},
abstract = {OBJECTIVE: To determine the ultrasonographic characteristics of limited dorsal myeloschisis (LDM) at prenatal ultrasound (US) and to highlight the main features that may help differentiate LDM and myelomeningocele (MMC).nnMETHODS: In a tertiary reference center in fetal medicine, we prospectively collected the medical data and ultrasonographic characteristics of all patients referred for in utero prenatal repair of MMC between November 1, 2013 and April 30, 2015.nnRESULTS: Among the 29 patients assessed, the diagnosis of MMC was revised in 7 cases. In 6 cases, the diagnosis of LDM was established. On US scan, LDM was characterized by a spinal saccular lesion with a thick peripheral lining in continuity with the adjacent skin. Within the saccular lesion, a thick hyperechoic well-delineated structure was present in continuity with the spinal cord. Cerebral structures were normal except for 2 cases showing a cisterna magna slightly decreased in size. In the remaining 22 cases MMC was confirmed, with cerebral anomalies present in 21/22 cases (95.5%).nnCONCLUSION: LDM is a form of closed dysraphism accessible to prenatal diagnosis by US that may mimic MMC. Considering the major difference in prognosis between these two entities, physicians should be aware of the existence and ultrasonographic characteristics of LDM.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To determine the ultrasonographic characteristics of limited dorsal myeloschisis (LDM) at prenatal ultrasound (US) and to highlight the main features that may help differentiate LDM and myelomeningocele (MMC).nnMETHODS: In a tertiary reference center in fetal medicine, we prospectively collected the medical data and ultrasonographic characteristics of all patients referred for in utero prenatal repair of MMC between November 1, 2013 and April 30, 2015.nnRESULTS: Among the 29 patients assessed, the diagnosis of MMC was revised in 7 cases. In 6 cases, the diagnosis of LDM was established. On US scan, LDM was characterized by a spinal saccular lesion with a thick peripheral lining in continuity with the adjacent skin. Within the saccular lesion, a thick hyperechoic well-delineated structure was present in continuity with the spinal cord. Cerebral structures were normal except for 2 cases showing a cisterna magna slightly decreased in size. In the remaining 22 cases MMC was confirmed, with cerebral anomalies present in 21/22 cases (95.5%).nnCONCLUSION: LDM is a form of closed dysraphism accessible to prenatal diagnosis by US that may mimic MMC. Considering the major difference in prognosis between these two entities, physicians should be aware of the existence and ultrasonographic characteristics of LDM.
Prenatal Sacral Anomalies Leading to the Detection of Associated Spinal Cord Malformations
Morel, Baptiste; Friszer, Stéphanie; Jouannic, Jean-Marie; Pointe, Hubert Ducou Le; Blondiaux, Eléonore; Garel, Catherine
In: Fetal Diagn Ther, vol. 42, no. 4, pp. 294–301, 2017, ISSN: 1421-9964.
@article{pmid28463829,
title = {Prenatal Sacral Anomalies Leading to the Detection of Associated Spinal Cord Malformations},
author = {Baptiste Morel and Stéphanie Friszer and Jean-Marie Jouannic and Hubert Ducou Le Pointe and Eléonore Blondiaux and Catherine Garel},
doi = {10.1159/000457795},
issn = {1421-9964},
year = {2017},
date = {2017-01-01},
journal = {Fetal Diagn Ther},
volume = {42},
number = {4},
pages = {294--301},
abstract = {INTRODUCTION: Systematic analysis of the spine is recommended as part of the basic sonographic examination. The aim of our study is to assess the proportion of spinal cord anomalies diagnosed following detection of a sacral anomaly.nnMATERIAL AND METHODS: We analyzed retrospectively collected data in a prenatal tertiary center during a 9-year period. Patients were referred for second-line ultrasound in the context of diabetes mellitus or following detection of pelvic or lower spine anomalies. We included all cases of sacral anomalies with available postnatal or postmortem outcomes (imaging and/or pathologic data) and excluded all cases of open dysraphism (myelomeningocele).nnRESULTS: Nineteen patients were included. The mean gestational age was 28 weeks (21-39). Sacral anomalies included 2 cases of complete agenesis, 12 cases of partial agenesis, 4 segmentation anomalies, and 1 case of abnormal angulation of the sacral spine. Fourteen associated spinal cord malformations included 8 tethered spinal cords, 5 truncated spinal cords, and 1 lipoma of the filum terminale. All anomalies were confirmed by postnatal or postmortem examinations.nnCONCLUSIONS: Sacral anomalies detected during basic sonographic examination represent an important warning sign for associated spinal cord anomalies, with possible poor neonatal outcome.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Systematic analysis of the spine is recommended as part of the basic sonographic examination. The aim of our study is to assess the proportion of spinal cord anomalies diagnosed following detection of a sacral anomaly.nnMATERIAL AND METHODS: We analyzed retrospectively collected data in a prenatal tertiary center during a 9-year period. Patients were referred for second-line ultrasound in the context of diabetes mellitus or following detection of pelvic or lower spine anomalies. We included all cases of sacral anomalies with available postnatal or postmortem outcomes (imaging and/or pathologic data) and excluded all cases of open dysraphism (myelomeningocele).nnRESULTS: Nineteen patients were included. The mean gestational age was 28 weeks (21-39). Sacral anomalies included 2 cases of complete agenesis, 12 cases of partial agenesis, 4 segmentation anomalies, and 1 case of abnormal angulation of the sacral spine. Fourteen associated spinal cord malformations included 8 tethered spinal cords, 5 truncated spinal cords, and 1 lipoma of the filum terminale. All anomalies were confirmed by postnatal or postmortem examinations.nnCONCLUSIONS: Sacral anomalies detected during basic sonographic examination represent an important warning sign for associated spinal cord anomalies, with possible poor neonatal outcome.
[Ultrasound screening for birth defects: A medico-economic review]
Ferrier, C; Dhombres, F; Guilbaud, L; Durand-Zaleski, I; Jouannic, J-M
In: Gynecol Obstet Fertil Senol, vol. 45, no. 7-8, pp. 408–415, 2017, ISSN: 2468-7189.
@article{pmid28720225,
title = {[Ultrasound screening for birth defects: A medico-economic review]},
author = {C Ferrier and F Dhombres and L Guilbaud and I Durand-Zaleski and J-M Jouannic},
doi = {10.1016/j.gofs.2017.06.007},
issn = {2468-7189},
year = {2017},
date = {2017-01-01},
journal = {Gynecol Obstet Fertil Senol},
volume = {45},
number = {7-8},
pages = {408--415},
abstract = {OBJECTIVES: The systematic use of ultrasound during pregnancy aims at birth defect detection. Our objective was to assess the economic efficiency of prenatal ultrasound screening for fetal malformations.nnMETHODS: We carried out a literature review on Medline via PubMed between 1985 and 2015, from the economic perspective of the prenatal ultrasound screening for fetal malformations.nnRESULTS: The literature on this subject was sparse and we selected only twelve articles presenting relevant economic data, of which only eight were proper medico-economic studies. We found arguments for the economic effectiveness of ultrasound screening for fetal malformation detection, which is largely linked to the terminations of pregnancies and to the cost of the handicaps "avoided". However, none of the reviewed articles could reach medico-economic conclusions. Additionally, we highlighted various elements making economic analyses more complex in this field: the choice of the method, the uncertainty around two essential parameters (the efficiency of ultrasound and the costs of procedures) and the difficulties to compare or to generalize results. We also noticed important methodological heterogeneity among the studies and the absence of French study.nnCONCLUSIONS: Previously published data are insufficient to assess the economic efficiency of prenatal ultrasound screening for fetal malformations.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: The systematic use of ultrasound during pregnancy aims at birth defect detection. Our objective was to assess the economic efficiency of prenatal ultrasound screening for fetal malformations.nnMETHODS: We carried out a literature review on Medline via PubMed between 1985 and 2015, from the economic perspective of the prenatal ultrasound screening for fetal malformations.nnRESULTS: The literature on this subject was sparse and we selected only twelve articles presenting relevant economic data, of which only eight were proper medico-economic studies. We found arguments for the economic effectiveness of ultrasound screening for fetal malformation detection, which is largely linked to the terminations of pregnancies and to the cost of the handicaps “avoided”. However, none of the reviewed articles could reach medico-economic conclusions. Additionally, we highlighted various elements making economic analyses more complex in this field: the choice of the method, the uncertainty around two essential parameters (the efficiency of ultrasound and the costs of procedures) and the difficulties to compare or to generalize results. We also noticed important methodological heterogeneity among the studies and the absence of French study.nnCONCLUSIONS: Previously published data are insufficient to assess the economic efficiency of prenatal ultrasound screening for fetal malformations.
[No title]
0000.
@proceedings{pmid38024482,
title = {[No title]},
keywords = {},
pubstate = {published},
tppubtype = {proceedings}
}