title: Trans-Pacific tele-ultrasound image transmission of fetal central nervous system structures.
abstract: OBJECTIVE
  To assess the quality of images and video clips of fetal central nervous (CNS) structures obtained by ultrasound and transmitted via tele-ultrasound from Brazil to Australia.
  
  
  METHODS
  In this cross-sectional study, 15 normal singleton pregnant women between 20 and 26 weeks were selected. Fetal CNS structures were obtained by images and video clips. The exams were transmitted in real-time using a broadband internet and an inexpensive video streaming device. Four blinded examiners evaluated the quality of the exams using the Likert scale. We calculated the mean, standard deviation, mean difference, and p values were obtained from paired t tests.
  
  
  RESULTS
  The quality of the original video clips was slightly better than that observed by the transmitted video clips; mean difference considering all observers = 0.23 points. In 47/60 comparisons (78.3%; 95% CI = 66.4-86.9%) the quality of the video clips were judged to be the same. In 182/240 still images (75.8%; 95% CI = 70.0-80.8%) the scores of transmitted image were considered the same as the original.
  
  
  CONCLUSIONS
  We demonstrated that long distance tele-ultrasound transmission of fetal CNS structures using an inexpensive video streaming device provided images of subjective good quality.
authors.affiliation: a Department of Perinatal Medicine, Royal Women's Hospital and Department of Obstetrics and Gynecology , University of Melbourne , Melbourne , Victoria , Australia .
authors.forename: Adilson Cunha
authors.initials: AC
authors.lastname: Ferreira
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.forename: Wellington P
authors.initials: WP
authors.lastname: Martins
authors.forename: João Francisco
authors.initials: JF
authors.lastname: Jordão
authors.forename: Antônio Hélio
authors.initials: AH
authors.lastname: Oliani
authors.forename: Simon E
authors.initials: SE
authors.lastname: Meagher
authors.forename: Fabricio
authors.initials: F
authors.lastname: Da Silva Costa
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D001938:Brazil; D002490:Central Nervous System / Q000000981:diagnostic imaging / Q000196:embryology*; D003430:Cross-Sectional Studies; D005260:Female; D047109:Fetal Development; D006801:Humans; D020407:Internet; D011247:Pregnancy; D016037:Single-Blind Method; D017216:Telemedicine / Q000379:methods*; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014741:Video Recording; D055815:Young Adult
keywords: Central nervous system; tele-ultrasound; telemedicine; telesonography; ultrasound