title: [A simple self-assessment tool for the first-trimester ultrasound images].
abstract: OBJECTIVE
  The objective of this study was to establish a minimum subset of simple criteria for the self-assessment of the quality of first-trimester ultrasound images of nuchal translucency (NT) and crown-rump length (CRL).
  
  
  METHODS
  We designed 162 simplified image-scoring methods (ISM) based on 1, 2, 3 or 4 binary criteria derived from the 8 criteria of the original image scoring method of the French College of Fetal Ultrasound (CFEF). These ISM were assessed on 68,250 consecutive scans of the French national audit conducted by the CFEF on NT and CRL images. The ISM associated with the best precision to identify excellent/reasonable quality scans were selected.
  
  
  RESULTS
  Simplified ISM based on 1, 2, 3 and 4 criteria showed maximum positive predictive values of 95.3% (95.11-95.50) 98.0% (97.87-98.14), 99.3% (99.17-99.35) and 99.7% (99.68-99.79), respectively, to identify excellent/reasonable quality scans. The proportion of excellent/reasonable scans was 2.8 to 16.7% when three criteria among the 8 were insufficient, and 0.17 to 3.95% when four criteria were insufficient.
  
  
  CONCLUSIONS
  The best performing ISM was based on the following four quality criteria: (i) sagittal plane of the NT, (ii) calipers placement for measuring the NT, (iii) image magnification of NT images and (iv) CRL measurement. This score might be the most relevant in clinical practice in the first-trimester screening.
authors.affiliation: Service de médecine fœtale & centre pluridisciplinaire de diagnostic prénatal de l'Est parisien, pôle de périnatalité, hôpital Armand-Trousseau, Assistance publique-Hôpitaux de Paris (AP-HP), UE, 26, avenue A.-Netter, 75012 Paris, France; Université Pierre-et-Marie-Curie (UPMC), UE, Paris, France; Collège français d'échographie fœtale (CFEF), UE, Paris, France. Electronic address: ferdinand.dhombres@trs.aphp.fr.
authors.forename: F
authors.initials: F
authors.lastname: Dhombres
authors.affiliation: Service de médecine fœtale & centre pluridisciplinaire de diagnostic prénatal de l'Est parisien, pôle de périnatalité, hôpital Armand-Trousseau, Assistance publique-Hôpitaux de Paris (AP-HP), UE, 26, avenue A.-Netter, 75012 Paris, France; Université Pierre-et-Marie-Curie (UPMC), UE, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Friszer
authors.affiliation: Collège français d'échographie fœtale (CFEF), UE, Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Bessis
authors.affiliation: Service de médecine fœtale & centre pluridisciplinaire de diagnostic prénatal de l'Est parisien, pôle de périnatalité, hôpital Armand-Trousseau, Assistance publique-Hôpitaux de Paris (AP-HP), UE, 26, avenue A.-Netter, 75012 Paris, France; Université Pierre-et-Marie-Curie (UPMC), UE, Paris, France; Collège français d'échographie fœtale (CFEF), UE, Paris, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Jouannic
mesh_terms: D018568:Crown-Rump Length; D004314:Down Syndrome / Q000000981:diagnostic imaging; D005260:Female; D005602:France; D005865:Gestational Age; D006801:Humans; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011785:Quality Assurance, Health Care; D011786:Quality Control; D016216:Ultrasonography, Prenatal
keywords: Auto-évaluation; Clarté nucale; Crown-rump length; First-trimester; Longueur crânio-caudale; Nuchal translucency; Premier trimestre; Prenatal ultrasound; Self-assessment; Échographie