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Publico-348d.pdf: 1649829 bytes, checksum: 07e95dcb838a25b79bd5a0093409b896 (MD5) === Objetivos: Verificar a reprodutibilidade do exame de ressonância magnética na aferição do comprimento do colo por meio da análise da variabilidade intra e interobservadores na segunda metade da gestação e comparar a ultrassonografia transvaginal e a ressonância magnética na aferição do comprimento cervical. Método: Estudo transversal observacional que incluiu 42 mulheres com idade gestacional entre 20 e 39 semanas submetidas inicialmente a ultrassonografia transvaginal por único observador para aferir o comprimento cervical. A seguir a ecografia, as pacientes foram submetidas à ressonância magnética e as medidas aferidas por observadores independentes de forma duplo-cega para análise das variabilidades intra e interobservadores. Resultados: Observou-se distribuição das medidas do colo uterino, aferidas por meio dos diferentes métodos segundo modelo de distribuição Gaussiano (teste de Komolgorov-Smirnov Z). Observou-se boa correlação (coeficiente de correlação intraclasse) para as medidas realizadas por ressonância magnética por único examinador 0,995 (IC 95%: 0,991 a 0,997; p<0,001) e por dois diferentes examinadores 0,990 (IC 95%: 0,995; p< 0,001). No cálculo do teste t pareado não houve diferença significativa entre as médias das medidas da cérvice para a análise da variabilidade intra e interobservadores (p= 0,200 e p= 0,257; respectivamente) confirmados pelo teste de Bland-Altman (-1,07% e 0,74%; respectivamente) que evidenciou pequena diferença média percentual. Não foi observada variação significativa entre as medidas realizadas pela USTV e RM no teste t pareado (p= 0,191) e no teste de Bland-Altman (-0,17%). Conclusões: Os resultados indicam boa reprodutibilidade do exame de RM na aferição do comprimento cervical e ausência de diferença significativa entre USTV e RM na estimativa da biometria cervical. === Objective: Verify the reproducibility of magnetic resonance imaging to measure the cervical length through the analysis of intra and interobserver variability in the second half of pregnancy and compare the transvaginal ultrasound and magnetic resonance imaging in the assessment of cervical length. Methods: Crosssectional observational study that included 42 women with gestational ages between 20 and 39 weeks initially submitted to transvaginal ultrasound by a single observer to measure the cervical length. After the scan, patients underwent magnetic resonance imaging by independent observers in a double-blind for the analysis of intra and interobserver variability. Results: There was a distribution of measurements of the cervix measured by means of different methods by Gaussian distribution model (Komolgorov-Smirnov test Z). There was good correlation (intraclass correlation coefficient) for the measurements performed by magnetic resonance single investigator 0.995 (95% CI: 0.991 to 0.997, p <0.001) and by two different examiners 0.990 (95% CI: 0.995, p <0.001). In calculating the paired t test no significant difference between the mean measurements of the cervix for the analysis of intra and interobserver variability (p = 0.200 and p = 0.257, respectively) confirmed by Bland-Altman (-1.07% and 0.74%; respectively) which showed a small average difference percentage. No significant variation was observed between measurements taken by transvaginal ultrasound and magnetic resonance imaging in the paired t test (p=0.191) and Bland-Altman (-0.17%). Conclusions: The results indicate good reproducibility of magnetic resonance imaging to measure the length cervical and no significant difference between transvaginal ultrasound and magnetic resonance imaging in the estimation of cervical biometry. === TEDE === BV UNIFESP: Teses e dissertações
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