MRI及四维超声在产前胎儿唇腭裂畸形诊断中的价值  

Prenatal Diagnostic Value of MRI and Four-Dimensional Ultrasound in Fetal Cleft Lip and Palate Malformation

作　　者：张理玲[1] 李亚敏[1] 王丽华[2] ZHANG Li-ling;LI Ya-min;WANG Li-hua(Department of Ultrasound,Puyang People's Hospital,Puyang 457000,Henan Province,China)

机构地区：[1]濮阳市人民医院超声科,河南濮阳457000 [2]濮阳市人民医院磁共振室,河南濮阳457000

出　　处：《中国CT和MRI杂志》2020年第12期35-37,F0003,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨核磁共振成像(MRI)及四维超声在产前胎儿唇腭裂畸形诊断中的价值。方法选取2016年3月至2018年4月医院经二维超声检查怀疑胎儿唇腭裂的孕妇36例,同时进行MRI和四维彩超复查,收集孕妇的影像学及其临床资料,对比超声和MRI诊断医师的检查结果。将产前四维超声、MRI诊断结果和产后随访结果进行比较,利用受试者工作特征曲线(ROC)分析两种检测手段在胎儿唇腭裂畸形诊断中的价值。结果产后随访胎儿患唇腭裂的孕妇共32例。胎儿唇裂诊断,四维超声和MRI均诊断正确,诊断正确率为100%;胎儿单纯腭裂的诊断,四维超声漏诊1例,MRI诊断正确率为100%;胎儿唇腭裂的诊断,四维超声漏诊8例,诊断正确率为65.27%;MRI漏诊1例,诊断正确率为95.65%,差异有统计学意义(P<0.05)。ROC曲线分析显示,四维超声和MRI曲线下面积分别为0.621、0.859。结论与四维超声相比,MRI诊断产前胎儿唇腭裂畸形优势明显;MRI联合四维超声检查有助于提高唇腭裂胎儿检出率。Objective To explore prenatal diagnostic value of magnetic resonance imaging(MRI)and four-dimensional ultrasound in fetal cleft lip and palate(CLP)malformation.Methods A total of 36 pregnant woman with suspected fetal CLP or unconspicuous normal maxillofacial structure examined by two-dimensional ultrasound in the hospital were enrolled during the period from March 2016 to April 2018.Reexamination was performed on them by MRI and four-dimensional ultrasound.The imaging and clinical data of pregnant women were collected.The diagnostic results of ultrasound and MRI were compared.The diagnostic results of prenatal four-dimensional ultrasound and MRI were compared with postpartum follow-up results.The receiver operating characteristic(ROC)curves were applied to analyze diagnostic value of the two detection methods in fetal CLP malformation.Results Postpartum follow-up showed that there were 32 pregnant women with fetal CLP.Diagnosis of CLP by four-dimensional ultrasound and MRI was correct,while diagnostic accuracy rate of 100%.In diagnosis of fetal simple cleft palate,there was 1 case with missed diagnosis by four-dimensional ultrasound,while diagnostic accuracy rate of MRI was 100%.In diagnosis of fetal CLP,there were 8 cases with missed diagnosis by four-dimensional ultrasound,with diagnostic accuracy rate of 65.27%.And there was 1 case with missed diagnosis by MRI,with diagnostic accuracy rate of 95.65%(P<0.05).ROC curve analysis showed that areas under the curves(AUC)of four-dimensional ultrasound and MRI were 0.621 and 0.859,respectively.Conclusion Compared with four-dimensional ultrasound,MRI has obvious advantages in the diagnosis of prenatal fetal cleft lip and palate;MRI combined with four-dimensional ultrasound is helpful to improve the detection rate of fetal cleft lip and palate.

关 键 词：唇腭裂 核磁共振 四维超声 产前诊断 

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