Reproducibility of Doppler Sonography Measurements of Fetal Cerebral Veins: a Study of the Transverse Sinus

Purpose: The aim of this study was to analyse the perfusion and reproducibility of the Pulsatility Index (PI) from recordings of the transverse sinus (TS) in the fetus. Material and Methods: We included 138 consecutive recordings from the TS. Wave-form analysis was performed by measuring the PI 2-5 times. We calculated the percent deviation of PI measurements using the variation coefficient and the single measure intraclass coefficient. Results: We were able to calculate a PI in 119/138 cases. In 14 cases we were unable to obtain any Doppler recording of sufficient quality. In another 3 cases we could not identify the heart cycle precisely and in two further cases we found a continuous flow pattern with very low velocities not suitable for PI calculation. In the remaining recordings 25% of the measurements had a variation coefficient of between 0-10%, 32% of between 10-20% and 43% had a variation coefficient of 20% or above. The single measure intraclass coefficient was 0.63 (0.27-0.91). Conclusion: The hemodynamic situation with very low velocities in the fetal TS makes it difficult to record wave forms in a clinical setting. The variation of the PI in the transverse sinus is high and appears to limit its diagnostic use.