title: Narrowed beam width in newer ultrasound machines shortens measurements in the lateral direction: fetal measurement charts may be obsolete.
abstract: OBJECTIVE
  Fetal ultrasound measurements are made in axial, lateral and oblique directions. Lateral resolution is influenced by the beam width of the ultrasound system. To improve lateral resolution and image quality, the beam width has been made narrower; consequently, measurements in the lateral direction are affected and apparently made shorter, approaching the true length. The aims of this study were to explore our database to reveal time-dependent shortening of ultrasound measurements made in the lateral direction, and to assess the extent of beam-width changes by comparing beam-width measurements made on old and new ultrasound machines.
  
  
  METHODS
  A total of 41,941 femur length measurements, collected during the time-period 1987-2005, were analyzed, with time as a covariate. Using three ultrasound machines from the 1990s and three newer machines from 2007, we performed 25 series of blinded beam-width measurements on a tissue-mimicking phantom, measuring at depths of 3-8 cm with a 5-MHz transducer.
  
  
  RESULTS
  Regression analysis showed time to be a significant covariate. At the same gestational age, femur length measurement was 1.15 (95% CI, 1.08-1.23) mm shorter in the time-period 1999-2005 than in the time-period 1987-1992. Overall, the beam width was 1.08 (95% CI, 0.50-1.65) mm narrower with the new machines than with the old machines.
  
  
  CONCLUSIONS
  Technical improvements in modern ultrasound machines that have reduced the beam width affect fetal measurements in the lateral direction. This has clinical implications and new measurement charts are needed.
authors.affiliation: National Center for Fetal Medicine, Department of Obstetrics and Gynecology, St Olavs University Hospital, Trondheim, Norway. iok@lyse.net
authors.forename: I
authors.initials: I
authors.lastname: Økland
authors.forename: T G
authors.initials: TG
authors.lastname: Bjåstad
authors.forename: T F
authors.initials: TF
authors.lastname: Johansen
authors.forename: H K
authors.initials: HK
authors.lastname: Gjessing
authors.forename: P
authors.initials: P
authors.lastname: Grøttum
authors.forename: S H
authors.initials: SH
authors.lastname: Eik-Nes
mesh_terms: D000704:Analysis of Variance; D001699:Biometry / Q000295:instrumentation*; D016208:Databases, Factual; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging* / Q000196:embryology; D006801:Humans; D019047:Phantoms, Imaging; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012016:Reference Values; D012044:Regression Analysis; D016216:Ultrasonography, Prenatal / Q000295:instrumentation* / Q000379:methods / Q000639:trends