Objective:To evaluate the application efficiency of the artificial prenatal sonography quality assurance system（PSAIS）in the quality control of fetal image quality during the first trimester（11-14 weeks），and to assist the quality control of fetal ultrasound examinations in the first trimester in Liaoning Province using this system.Methods:One hundred fetuses（2 757 ultrasound images）from early pregnancy ultrasound screenings at the Shengjing Hospital Affiliated to China Medical University in November 2022 were retrospectively randomly selected as the test set. The performance of PSAIS were evaluated by 3 obstetric ultrasound experts. First，the experts' sectional classification was used as the gold standard，the accuracy of PSAIS in classifying standard sections was assessed；the consistency between PSAIS and expert ratings was evaluated using the intraclass correlation coefficient（ICC）. The difference of time between PSAIS and expert quality control was analyzed. Finally，PSAIS was used to evaluate the quality of early pregnancy fetal ultrasound examinations at various levels of hospitals in Liaoning province，involving a total of 35 hospitals. Ten early pregnancy fetal ultrasound screening cases were randomly selected from each hospital. The specific evaluation content included the number of stored ultrasound images per examination，the completion rate of standard sections，image quality scores for each examination and individual images，excellence rates and pass rates. The assessment results were statistically described and analyzed.Results:The accuracy rate of PSAIS classification reached to 88.25%（706/800）；the ICC between PSAIS and expert ratings was 0.978. PSAIS analysis showed that the time for each early pregnancy fetal ultrasound examination was less than the average time required by experts（3.0 s vs. 63.5 s， P<0.05）.Quality control checks revealed statistically significant differences among hospitals at various levels in terms of the number of stored images，completeness of sections，scoring，excellence rate，and pass rate（all P<0.05）. Among them，tertiary hospitals performed better than secondary hospitals，private hospitals outperformed public ones，and specialized hospitals excelled over general hospitals. In the evaluation of section standardization，the fetal median sagittal plane had the highest completion rate［99.43%（348/350）］，while the umbilical cord abdominal wall entry transverse plane scan had the lowest completion rate［31.14%（109/350）］. Conclusions:PSAIS can reliably assess the quality of early pregnancy fetal ultrasound examinations，significantly enhancing the efficiency of quality control. There are noticeable differences among hospitals at various levels in Liaoning Province regarding the image quality of early pregnancy fetal ultrasounds，and there are also some common issues in standardizing sections. The quality of obstetric ultrasound images still needs further improvement.

Objective:To evaluate the application efficiency of the artificial prenatal sonography quality assurance system（PSAIS）in the quality control of fetal image quality during the first trimester（11-14 weeks），and to assist the quality control of fetal ultrasound examinations in the first trimester in Liaoning Province using this system.Methods:One hundred fetuses（2 757 ultrasound images）from early pregnancy ultrasound screenings at the Shengjing Hospital Affiliated to China Medical University in November 2022 were retrospectively randomly selected as the test set. The performance of PSAIS were evaluated by 3 obstetric ultrasound experts. First，the experts' sectional classification was used as the gold standard，the accuracy of PSAIS in classifying standard sections was assessed；the consistency between PSAIS and expert ratings was evaluated using the intraclass correlation coefficient（ICC）. The difference of time between PSAIS and expert quality control was analyzed. Finally，PSAIS was used to evaluate the quality of early pregnancy fetal ultrasound examinations at various levels of hospitals in Liaoning province，involving a total of 35 hospitals. Ten early pregnancy fetal ultrasound screening cases were randomly selected from each hospital. The specific evaluation content included the number of stored ultrasound images per examination，the completion rate of standard sections，image quality scores for each examination and individual images，excellence rates and pass rates. The assessment results were statistically described and analyzed.Results:The accuracy rate of PSAIS classification reached to 88.25%（706/800）；the ICC between PSAIS and expert ratings was 0.978. PSAIS analysis showed that the time for each early pregnancy fetal ultrasound examination was less than the average time required by experts（3.0 s vs. 63.5 s， P<0.05）.Quality control checks revealed statistically significant differences among hospitals at various levels in terms of the number of stored images，completeness of sections，scoring，excellence rate，and pass rate（all P<0.05）. Among them，tertiary hospitals performed better than secondary hospitals，private hospitals outperformed public ones，and specialized hospitals excelled over general hospitals. In the evaluation of section standardization，the fetal median sagittal plane had the highest completion rate［99.43%（348/350）］，while the umbilical cord abdominal wall entry transverse plane scan had the lowest completion rate［31.14%（109/350）］. Conclusions:PSAIS can reliably assess the quality of early pregnancy fetal ultrasound examinations，significantly enhancing the efficiency of quality control. There are noticeable differences among hospitals at various levels in Liaoning Province regarding the image quality of early pregnancy fetal ultrasounds，and there are also some common issues in standardizing sections. The quality of obstetric ultrasound images still needs further improvement.

Purpose: This study explored the performance of prenatal ultrasonography in the differential diagnosis of cystic biliary atresia (CBA) and choledochal cyst (CC). Methods: Fetuses diagnosed with hepatic hilar cyst in the second trimester were included in this study. A series of prenatal ultrasound examinations were performed in the second and third trimesters. The diameter of the gallbladder (GB) and hepatic cyst were measured, as well as the wall thickness of the GB. The GB-cyst connection, visibility of the right hepatic artery (RHA), and other concomitant abnormalities were carefully evaluated. A neonatal transabdominal ultrasound examination was performed within 1 week after birth, and clinical data were followed up to 6 months after birth. Results: Between January 1, 2016 and January 31, 2020, 53 fetuses diagnosed with hepatic hilar cyst were recruited. Eight were excluded because they were lost to follow-up. Among the 45 cases included in this study, 10 were diagnosed with CBA and 35 with CC after birth. Statistically significant differences were found in GB width, wall thickness, change in GB width, change in cyst length, GB-cyst connection, and RHA visibility between the CBA and CC groups. GB width showed the best diagnostic performance with an area under the curve (AUC) of 0.899. The combination of GB width, GB wall thickness, and GB-cyst connection yielded a comparable AUC of 0.971. Conclusion The GB should be carefully evaluated in fetuses with hepatic hilar cyst. Prenatal ultrasound findings could provide suggestive parameters for the differential diagnosis of CBA from CC.