高频线阵探头产前诊断胎儿融合肾的应用研究  

Application of high-frequency linear array probe in prenatal diagnosis of fetal kidney fusion anomalies

作　　者：尚宁[1] 舒爽 潘云祥[1] 徐玲[1] 刘风华[2] Shang Ning;Shu Shuang;Pan Yunxiang;Xu Ling;Liu Fenghua(Department of Ultrasound,Guangdong Women and Children′s Hospital,Guangzhou 511400,China;Department of President Office,Guangdong Women and Children′s Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院超声诊断科,广州511400 [2]广东省妇幼保健院院长室,广州511400

出　　处：《中华超声影像学杂志》2020年第5期439-442,共4页Chinese Journal of Ultrasonography

基　　金：国家重点研发计划(2018YFC1002604)。

摘　　要：目的:探讨高频线阵探头超声产前诊断胎儿融合肾的应用价值。方法:一位高年资产前超声检查医生分别使用普通凸阵探头和高频线阵探头对2018年12月至2019年10月广东省妇幼保健院27例可疑或诊断肾窝空虚、肾脏位置异常、肾脏轮廓形态异常的胎儿进行泌尿系统的详细检查,获取胎儿肾脏横切面、矢状面、冠状面及异位的肾脏图像并存储。由另一位高年资医师(受试者1)和一位相对低年资医师(受试者2)对图像是否为融合肾进行分级诊断,根据出生后随访结果绘制ROC曲线,并进行统计分析,计算两位受试者之间的Kappa系数。结果:两位受试者判读凸阵探头采集图像时ROC曲线下面积分别为0.969和0.756,判读高频线阵探头采集图像时ROC曲线下面积均为1.000。受试者1在使用两种探头的准确性差异无统计学意义(P>0.05),而受试者2在使用高频线阵探头时诊断准确性更高(P<0.05)。使用高频线阵探头受试者之间的一致性比凸阵探头高,Kappa系数分别为1.000和0.516。结论:应用高频线阵探头产前诊断胎儿融合肾可行,并可提高超声医师的诊断信心和诊断准确性。Objective To investigate the application value of high-frequency linear array probe in prenatal ultrasound diagnosis of fetal kidney fusion anomalies.Methods A senior sonographer for prenatal diagnosis used a convex array probe and a high-frequency linear array probe to obtain and store renal images of the transverse section,sagittal and coronal plane and ectopic kidney of 27 fetuses with suspected or diagnosed fetal renal fossa emptiness,abnormal renal position and abnormal renal contour in Guangdong Women and Children Hospital from December 2018 to October 2019.The images were analyzed to judge the possibility of kidney fusions by another senior sonographer(subject 1)and a junior sonographer(subject 2)separately.Then,ROC curves were plotted and statistically analyzed based on postnatal follow-up results.The Kappa coefficient between the two subjects was calculated.Results Areas under the two ROC curves were 0.969 and 0.756 when using a convex array probe,but 1.000 and 1.000 with a high-frequency linear array probe by two subjects separately.Subject 1 had no significant difference using two kinds of probes(P>0.05),however,subject 2 had higher diagnostic accuracy when using high frequency linear array probes(P<0.05).The diagnostic consistence of high-frequency linear array probe between subjects was higher than convex array probe,the Kappa coefficients were 1.000 and 0.516,respectively.Conclusions The application of high-frequency linear array probe in prenatal diagnosis of fetal kidney fusion anomalies is feasible,and can improve the confidence and diagnostic accuracy for fetal kidney fusion anomalies.

关 键 词：超声检查 产前 胎儿融合肾 高频线阵探头 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]