Re: [ultrasonlist-gyneco] Re: nasal Bones in T1
From: Alain LEBOEUF (leboeuf.alain@wanadoo.fr)
Thu Nov 22 16:05:15 2001
DEARS FRIENDS,
I hope ,really,Boujemaa, get the explanation about this caution .
What does he think about nasal bones synchondrosis ??
we have lost long way off,nice in one's mind .
greats dammages .
Alain Leboeuf
échogène.
>----- Original Message -----
From: "Philippe Coquel" <philippe.coquel@wanadoo.fr>
To: <ultrasound@obgyn.net>
Cc: <ultrasonlist-gyneco@yahoogroupes.fr>; "echolist"
<echolist@liste.gyneweb.fr>
Sent: Thursday, November 22, 2001 5:54 PM
Subject: [ultrasonlist-gyneco] Re: nasal Bones in T1
> In fact, there are two problems
>
> The paper by F Guy et all speaks about the length of the nasal bone after
14
> wa and not before as in the paper of Cicero et al. This is a good but
only
> a biometry paper
>
> The second problem is more complex
>
> First, the paper, in French,
>
> ( [Trisomy 21. 209 cases from the French College of Fetal Ultrasonography.
> Pertinence of ultrasonographic signs].
> Contracept Fertil Sex. 1997 Dec;25(12):VII-XIV. French. No abstract
> available.
> PMID: 9497609 [PubMed - indexed for MEDLINE]
>
> has been published in a scientific journal without abstract available
in
> Medline. The great majority of sonologists and sonographers in the world
> don't know this paper because it is in French and because key words
research
> is difficult without abstract.
>
> Second and more important: The idea and the collect of cases are good but
> this is only a series of cases without control group. It is not possible
to
> calculate specificity and LR. More ever, the description of nasal bone
> abnormalities is some confuse in this paper mixing absence of
visualisation
> of the nasal bone synchondrosis and short nasal bones. In the anomalies of
> the face, same signs are used twofold and then, calculations are wrong.
>
> Because of these major mistakes of methodology, the results of the paper
> cannot be used in conjunction with the others markers of the trisomy 21
> during the second trimester.
>
> Now, we use in practice ( for almost of us) only nasal bones visualisation
> or not, without short nasal bone sign in addition of soft markers
>
> It is for this reason that I make some comments last year to try to have a
> study about the problem with a control group and to know the real
> sensitivity and specificity of this sign.
>
> We don't have great data bases in France
>
> It's a big problem to do studies with correct statistic basis.
>
> I don't know if members of Nicolaides staff have read the comments but the
> main thing is the realisation of their study between January and October
> 2001 (five months later after the discussion here)
>
> Their great idea is to have used the 11-14 we exam and not like in France
> the 22wa exam. Then , main signs of trisomy 21 can be seen during the
exam
> of 11-14 wa
>
> The second thing is the very nice and correct statistical analysis. It is
> fundamental before use a diagnostic test in routine
>
> The third is the quality of their conclusions and the comments of H Cuckle
..
>
> Now, we are waiting for confirmation by others studies but I think that
this
> paper is a giant leap
>
> Ph Coquel, MD
>
> Dr. Coquel, I agree this is both interesting and exciting; but how is
> this different from your report here:
> http://www.obgyn.net/us/us.asp?page=/us/present/0009/nasal_bones
>
> or how different from the comments you made in this forum in August
> 2000? See:
> http://forums.obgyn.net/ultrasound/ULTRASOUND.0008/0053.html
>
> and: http://forums.obgyn.net/ultrasound/ULTRASOUND.0008/0051.html
>
> http://forums.obgyn.net/ultrasound/ULTRASOUND.0008/0049.html
>
> I also notice that the current article did not reference Le Duff, which
> you did reference here in August, 2000: "Le Duff, 1997 Trisomy 21. 209
> cases from the french college of fetal ultrasonography. Pertience of
> ultrasound Contracept Fertil Sex 1997 25 12 VII,XIV TRISOMIE 21 237 Cas
> colligés par le Collège Français"
>
> The Cicero, et al article has very nice statistical analysis, but it
> does seem that they would at least give the prior publications on the
> nasal bone observation a reference. At any rate, thanks for the heads
> up on this article.
>
> Peace, Terry J DuBose, M.S., RDMS, APS
> University of Arkansas for Medical Sciences
>
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