广州地区早孕期超声测量胎儿颈项透明层图像质量分析  

Analysis of Ultrasonographic Imaging Quality of Nuchal Translucency Measurement during the First-Trimester in Guangzhou: A Report of 232 Cases

作　　者：杨烨 马毅敏 李娟 黄花妮 刁伟坚 吴伟雄 

机构地区：[1]广州市人口和计划生育科学研究所优生遗传科,广州510410

出　　处：《临床误诊误治》2015年第4期100-103,共4页Clinical Misdiagnosis & Mistherapy

基　　金：国家十一五科技支撑计划(2006BAI05A02);广东省计生委基金支持项目(2008003)

摘　　要：目的探讨提高超声医师早孕期胎儿超声筛查能力的方法。方法对广州地区232例孕11~13＋6周妇女超声测量胎儿颈项透明层（nuchal translucency,NT）的图像质量进行回顾性分析,对照英国胎儿医学基金会超声测量早孕期胎儿NT图像标准,记录所有胎儿超声报告中头臀径（CRL）以及胎儿头胸部占超声显像图面比例、胎儿姿势、胎儿皮肤与羊膜区分是否清晰、游标尺放置位置等情况,并分析该地区不同等级医院上述胎儿超声图像质量达标情况。结果 232例超声报告中228例（98.28%）CRL测值符合标准;203例（87.50%）可显示胎儿轮廓,其中127例（62.56%）图像放大倍数未达要求,76例（37.44%）胎儿头胸部占超声显像图面比例≥75%,19例（9.36%）显示胎儿正中矢状面,107例（52.71%）胎儿自然平躺,67例（33.00%）可以清楚区分胎儿皮肤与羊膜,33例（45.83%）游标尺度量位置正确。除CRL达标、游标尺放置位置正确外,上述余早孕期超声NT图像质量指标,二、三级甲等医院比较差异均有统计学意义（P〈0.05或P〈0.01）。结论对操作者的培训、足够的实践经验、建立一套定期审核及持续评定影像质量的机制是提高超声医师早孕期胎儿超声筛查能力的有效措施。Objective To study the method of improving sonographer＇s skills during the first-trimester screening.Methods A total of 232 nuchal translucency measurement reports in Guangzhou were studied and compared with the standard of FMF. All key points of the images such as CRL,the proportion of fetal cephalothorax,posture of the fetus,the division among skin and amnion,location of the cursors were recorded. The results of different hospitals up to the standard were studied. Results Among 232 records,228 cases（ 98. 28%） of their CRL were suitable. There were 203 cases（ 87. 50%） clearly showed fetal lineament,127 cases（ 62. 56%） imaging magnifications were not up to the standard,76 cases（ 37. 44%）imaging proportions of fetal cephalothorax≥75%,19 cases（ 9. 36%） showed median sagittal section,107 cases（ 52. 71%）lay low,67 cases（ 33. 00%） clearly showed the division among skin and amnion,33 cases（ 45. 83%） showed the right location of cursors for NT measurement. The comparison of ultrasonographic image in nuchal translucency measurement between first-class hospitals and second class hospitals showed statistically significant difference（ P〈0. 05 or P〈0. 01）,except that CRL was out of range and cursors were in right location. Conclusion Training,experience of adequate practice and ongoing quality assessment are effective measures to improve sonographer＇s technological skills.

关 键 词：超声检查 产前 颈部透明带检查 质量控制 先天畸形 

分 类 号：R714.53[医药卫生—妇产科学]