A Proposed Method to Quantify Vitreous Hemorrhage by Ultrasound
Authors Salcedo-Villanueva G, Trujillo-Alvarez M, Becerra-Revollo C, Ibarra-Elizalde E, Mayorquín-Ruiz M, Velez-Montoya R, García-Aguirre G, Gonzalez-Salinas R, Morales-Cantón V, Quiroz-Mercado H, Moragrega-Adame E
Received 4 September 2019
Accepted for publication 21 November 2019
Published 2 December 2019 Volume 2019:13 Pages 2377—2384
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Guillermo Salcedo-Villanueva,1 Manuel Trujillo-Alvarez,1 Catalina Becerra-Revollo,2 Estefanía Ibarra-Elizalde,2 Mariana Mayorquín-Ruiz,2 Raul Velez-Montoya,1 Gerardo García-Aguirre,1 Roberto Gonzalez-Salinas,3 Virgilio Morales-Cantón,1 Hugo Quiroz-Mercado,1 Eduardo Moragrega-Adame2
1Retina Department, Asociación Para Evitar La Ceguera En México, Mexico City, Mexico; 2Ocular Ultrasound Department, Asociación Para Evitar La Ceguera En México, Mexico City, Mexico; 3Research Department, Asociación Para Evitar La Ceguera En México, Mexico City, Mexico
Correspondence: Guillermo Salcedo-Villanueva
Retina Department, Asociación Para Evitar La Ceguera En México, Vicente García Torres #46. Col. San Lucas, Coyoacán, Mexico City 04030, Mexico
Purpose: To propose a method for quantification of vitreous hemorrhages (VH) termed minimum image gain (MIG). Therefore, to obtain MIG measurements in patients with VH and to compare them to normal controls; to compare results between graders; and to obtain and compare MIG from two different ultrasound systems.
Methods: Retrospective and cross-sectional, observational, and comparative study performed in two parts: Part 1) Retrospective comparison of MIG in VH vs controls by two experienced graders, with intra/inter-observer variability: MIG technique is described. MIG is performed retrospectively in two groups, VH patients and normal controls. Groups are compared with independent samples t-test. Intra- and interobserver variability between graders was obtained. Part 2) Cross-sectional analysis of variability from nonexperienced graders and with different ultrasound systems: MIG is performed in cross-sectional measurements of VH patients, by two unexperienced graders, and with two ultrasound systems. Interobserver variability and Bland–Altman plot with levels of agreement (LoA) were obtained.
Results: Part 1: 50 patients with VH resulted in mean MIG: 52.8 dB; 34 controls resulted in mean MIG: 77.97 dB. Independent samples t-test resulted in a statistical significant difference. Intra- and inter-observer variability resulted in an almost perfect agreement between experienced graders. Part 2: 63 patients with VH, mean MIG: 56.19 dB. Inter-observer variability resulted in a very high agreement between unexperienced observers. LoA resulted in a statistical difference between the two ultrasound systems.
Conclusion: MIG may provide an objective and reproducible way to quantify vitreous hemorrhage density and potentially any vitreous humor opacity. Agreement is high even with unexperienced graders. However, the two ultrasound systems analyzed may not be interchangeable.
Keywords: diagnostic imaging, retina, ultrasonography, vitreous hemorrhage, vitreous humor
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