孕中期四维彩超联合胎儿颈项透明层厚度超声在妊娠期胎儿体表畸形中的应用  

APPLICATION OF FOUR-DIMENSIONAL COLOR DOPPLER ULTRASOUND COMBINED WITH FETAL NECK TRANSPARENT LAYER THICKNESS ULTRASOUND IN PREGNANCY WITH FETAL SURFACE DEFORMITY

作　　者：杨晓君 李云竹 刘迎辉 李梦雪 Yang Xiaojun;Li Yunzhu;Liu Yinghui(Functional Inspection Section,Guangyuan Hospital of Traditional Chinese Medicine,Guangyuan 628000,China)

机构地区：[1]四川省广元市中医医院功能检查科

出　　处：《中国煤炭工业医学杂志》2019年第5期459-463,共5页Chinese Journal of Coal Industry Medicine

基　　金：四川省卫生厅科研项目(编号:150114)

摘　　要：目的研究妊娠11~13^+6周胎儿颈项透明层(NT)检测联合妊娠22~28周四维彩超(4D-US)检查在胎儿体表畸形筛查中的应用效果。方法选取2015年12月-2018年12月我院2974例胎儿的临床资料进行回顾性分析,比较妊娠11~13^+6周NT检测和妊娠22~28周4D-US检查结果并分析两种检查方法单独及联合应用时对胎儿体表畸形诊断价值。结果引产及分娩结果证实,2974例胎儿中体表畸形61例,发病率2.05%,其中NT超声(NT≥3.0mm为阳性)检出52例(85.25%),4D-US检查则发现58例(95.08%);体表畸形胎儿NT值明显高于正常胎儿(P<0.05),二组NT异常率分别为85.25%和2.09%(P<0.05);61例患儿共存在畸形109处,4D-US对全部胎儿体表畸形检出率为88.99%,其中唇裂漏检2处,检出率为90.91%,脊柱裂漏检5处,短肢畸形漏检1处,足内翻漏检1处及多部位畸形漏检3处;NT超声检查、4DUS及两者联合检测诊断胎儿体表畸形灵敏度分别为85.25%、95.08%和98.36%,特异度分别为97.91%、99.18%和99.83%,准确度分别为97.65%、99.09%和99.80%,一致性Kappa值分别为0.587、0.807和0.951。结论妊娠11~13^+6周NT检测和妊娠22~28周4D-US检查对胎儿体表畸形均具有良好诊断价值,两种方法联合应用,充分发挥各自优势有利于进一步提升诊断准确率。Objective To study the effects of fetal nuchal translucency(NT)detection in the 11-13^+6 weeks of pregnancy combined with four-dimensional color Doppler ultrasound(4 D-US)examination in the 22-28 weeks of pregnancy in the fetal surface malformations screening.Methods From December 2015 to December 2018,the clinical data of two thousand nine hundred and seventy-four cases of fetuses in Guangyuan Hospital of Traditional Chinese Medicine were retrospectively analyzed.The examination results of NT detection in the 11-13^+6 weeks of pregnancy and 4 D-US in the 22-28 weeks of pregnancy were compared,and the diagnostic value of the two examination methods and combined examination for fetal surface malformations was analyzed.Results The results of induced labor and delivery confirmed that there were 61 cases of fetal surface abnormalities in 2974 cases,and the incidence was 2.05%.Among them,52 cases(85.25%)were detected by NT ultrasound(NT>3.0 mm was positive),58 cases(95.08%)were detected by 4 D-US examination.The NT value of fetal surface abnormalities was significantly higher than that of normal fetuses(P<0.05),and the abnormal rates of NT in the two groups were 85.25%and 2.09%(P<0.05),respectively.There were 109 malformations in 61 children.The detection rate of fetal surface deformities by 4 D-US was 88.99%.The detection rate of cleft lip was 90.91%,leakage of spinal bifida was 1,short limb was 1,foot varus was 1 andmulti-site deformity was 3.The sensitivity of NT ultrasound,4 D-US and their combined detection for fetal surface deformities was 85.25%,95.08%and 98.36%,the specificity was 97.91%,99.18%and 99.83%,respectively.The accuracy was 97.65%,99.09%and 99.80%respectively.The consistency Kappa values were 0.587,0.807 and 0.951,respectively.Conclusion Both NT detection in the 11-13^+6 weeks of pregnancy and 4 D-US examination in the 22-28 weeks of pregnancy have good diagnostic value for fetal surface malformations.The combination of the two methods can further improve the diagnostic accuracy rate with their respe

关 键 词：胎儿体表畸形 孕中期四维彩超 胎儿颈项透明层厚度超声 产检筛查 

分 类 号：R714.53[医药卫生—妇产科学]