Accuracy of Ultrasonographic Transcerebellar Diameter for Gestational Age Estimation: A Systematic Review and Meta-Analysis

IF 1.3 4区医学 Q3 ACOUSTICS

Journal of Clinical Ultrasound Pub Date : 2026-10-06 Epub Date: 2026-06-17 DOI:10.1002/jcu.70300

Ammar Elgadi, Mohammed Wagealla, Elwalid Idris, Abdullatif Yasir H. Eissa, Sara Altraifi, Hajir Altraifi, Eman Abdallah, Tibyan Noorallah, Eltayeb AbdAlla

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引用次数: 0

Abstract

Background

Accurate estimation of gestational age (GA) is essential in prenatal care and assessment of perinatal outcomes. Standard dating methods such as last menstrual period (LMP) or conventional ultrasound biometry may be limited by fetal position, late antenatal booking, or intrauterine growth restriction (IUGR). The transcerebellar diameter (TCD) has been proposed as a robust alternative for GA estimation, particularly in late gestation or when other methods are unreliable. This study systematically evaluates the accuracy of TCD-based GA estimation in the second and third trimesters in both normal and IUGR pregnancies.

Methodology

We conducted a systematic review and meta-analysis in accordance with the PRISMA guidelines. Databases including PubMed, Scopus, and ScienceDirect were searched from inception through July 2025 for studies assessing the correlation between TCD and GA. Google Scholar was also searched for relevant articles. Inclusion criteria were original studies reporting correlation coefficients between TCD and GA determined by LMP or first-trimester ultrasound. Data extraction and risk of bias assessments were performed independently by two reviewers. Meta-analyses were conducted using random-effects models in R.

Results

In this meta-analysis of 47 studies comprising 24 825 participants, the pooled correlation between TCD and GA was consistently strong. In the third trimester, r = 0.94 (95% CI: 0.89–0.97); in the second trimester, r = 0.93 (95% CI: 0.87–0.96); and across the combined second or third trimester, r = 0.98 (95% CI: 0.97–0.98). This was comparable to other fetal biometric parameters: BPD (r = 0.97), HC (r = 0.97), FL (r = 0.98), and AC (r = 0.97), with no statistically significant differences in pairwise comparisons (p > 0.05). In pregnancies affected by IUGR, TCD correlation with GA (r = 0.94, 95% CI: 0.89–0.97) was significantly higher than that of other biometric measures: BPD (r = 0.69), HC (r = 0.72), FL (r = 0.80), and AC (r = 0.78) (p < 0.001).

Conclusion

TCD is a reliable and highly reproducible parameter for gestational age estimation, with strong correlations in late pregnancy. In pregnancies affected by IUGR, TCD was superior to other parameters. Its short learning curve and standardized methodology support its clinical utility as a complementary or primary tool for GA assessment, particularly in late pregnancy or when standard methods are limited.

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超声经小脑直径对胎龄估计的准确性：一项系统综述和荟萃分析。

背景：准确估计胎龄（GA）是必要的产前护理和围产期结局的评估。标准的测定方法，如最后一次月经（LMP）或传统的超声生物测定法可能受到胎儿位置、产前后期预约或宫内生长受限（IUGR）的限制。经小脑直径（TCD）已被提出作为遗传算法估计的鲁棒替代方案，特别是在妊娠晚期或当其他方法不可靠时。本研究系统地评估了在正常妊娠和IUGR妊娠中基于tcd的妊娠中期和晚期GA估计的准确性。方法：我们按照PRISMA指南进行了系统回顾和荟萃分析。数据库包括PubMed， Scopus和ScienceDirect从成立到2025年7月进行了检索，以评估TCD和GA之间的相关性。b谷歌Scholar也搜索了相关文章。纳入标准是通过LMP或妊娠早期超声确定TCD和GA之间相关系数的原始研究。数据提取和偏倚风险评估由两名审稿人独立完成。采用随机效应模型进行meta分析。结果：在这项包含24825名参与者的47项研究中，TCD和GA之间的综合相关性一直很强。在妊娠晚期，r = 0.94 (95% CI: 0.89-0.97)；妊娠中期，r = 0.93 (95% CI: 0.87-0.96)；在妊娠中期或晚期，r = 0.98 （95% CI: 0.97-0.98）。这与其他胎儿生物特征参数：BPD （r = 0.97）、HC （r = 0.97）、FL （r = 0.98）、AC （r = 0.97）相当，两两比较无统计学差异（p < 0.05）。在IUGR影响的妊娠中，TCD与GA的相关性（r = 0.94, 95% CI: 0.89-0.97）显著高于BPD （r = 0.69）、HC （r = 0.72）、FL （r = 0.80）和AC (r = 0.78) (p结论：TCD是一个可靠且高度可重复的胎龄估计参数，在妊娠后期具有很强的相关性。在IUGR影响的妊娠中，TCD优于其他参数。其较短的学习曲线和标准化的方法支持其作为GA评估的补充或主要工具的临床效用，特别是在妊娠晚期或标准方法有限的情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Ultrasound 医学-核医学

CiteScore

1.90

自引率

0.00%

发文量

248

审稿时长

6 months

期刊介绍： The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography. The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents. JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.