二维联合三维诊断在11~14孕周胎儿颅脑畸形中的价值  

The value of two dimensions combined with three dimensions in the diagnosis of cephalic and anencephaly in fetuses at 11~14 weeks of gestation

作　　者：秦博[1] 赵小利[1] 牛静[1] 杨丽娟 陈胜江[1] QIN Bo;ZHAO Xiaoli;NIU Jing;YANG Lijuan;CHEN Shengjiang(Department of Ultrasound, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471000, P.R.China)

机构地区：[1]河南科技大学第一附属医院超声科,河南洛阳471000

出　　处：《医学影像学杂志》2021年第1期12-15,28,共5页Journal of Medical Imaging

基　　金：河南省科技攻关项目(编号:2018020268)。

摘　　要：目的探讨二维联合三维在诊断在11~14孕周胎儿颅脑畸形中的诊断价值。方法选取我院疑似露脑-无脑畸形的孕11~14周孕妇78例,行超声检测,对产妇早孕期胎儿露脑与无脑畸形引产结果进行追踪,并对继续妊娠孕妇孕中期超声情况及妊娠结局进行随访。结果78例疑似露脑-无脑畸形的孕11~14周孕妇经超声筛查、引产及病理检查确诊,露脑与无脑畸形共72例。其中露脑畸形胎儿39例,无脑畸形胎儿33例。其中二维超声的检出率为91.67%,漏诊率为5.56%,误诊率为2.78%;三维超声的检出率为94.44%,漏诊率为4.17%,误诊率为1.39%。二维超声检查检测胎儿露脑与无脑畸形的准确率为88.9%(64/72),三维超声检测胎儿露脑与无脑畸形的准确率为93.06%(67/72),二者联合检查胎儿露脑与无脑畸形的准确率为98.6%(71/72)。ROC曲线分析显示,二维超声、三维超声及二者联合诊断胎儿露脑与无脑畸形的AUC为0.778、0.882、0.910,敏感度、特异度:二维超声为88.9%、66.7%,三维超声为93.1%、83.3%,二者联合为98.6%、83.3%,联合诊断价值较高。结论二维联合三维对孕11~14周胎儿露脑与无脑畸形序列具有较高的诊断价值,对早期胎儿颅脑畸形的筛查具有重要作用。Objective To explore the diagnostic value of two dimensions combined with three dimensions in the diagnosis of cephalic and anencephaly in fetuses at 11~14 weeks of gestation.Methods A total of 78 pregnant women of 11 to 14 weeks of gestation who were suspected to have luencephalopathy and underwent antenatal examination in our hospital from March 2017 to March 2020 were selected as study subjects.All the pregnant women were tested by 2D and 3D ultrasound,and the induced labor results of the fetuses in early pregnancy were tracked,and the ultrasound status and pregnancy outcome of the pregnant women who were continuing their pregnancy were followed up.Results Seventy-eight pregnant women with suspected denaencephalopathy at 11 to 14 weeks of gestation were found to have a total of 72 cases of denaencephalopathy by ultrasound screening,labor induction and pathological examination.Among them,there were 39 cases(54.17%)of deanencephaly fetuses and 33 cases(45.83%)of anencephaly fetuses.The detection rate of 2 d ultrasound was 91.67%,the missed diagnosis rate was 5.56%and misdiagnosis rate was 2.78%.The detection rate of 3D ultrasound was 94.44%,the missed diagnosis rate was 4.17%,and misdiagnosis rate was 1.39%.The accuracy of 2D ultrasonography was 88.9%(64/72),3D ultrasonography was 93.06%(67/72),and the combination of the two was 98.6%(71/72).The ROC curve analysis showed that the AUC of two dimensional ultrasound,three dimensional ultrasound and the combination of them in the diagnosis of foetal lobectomy and anencephaly was 0.778,0.882 and 0.910,the sensitivity and specificity were 88.9%and 66.7%for two dimensional ultrasound,93.1%and 83.3%for three-dimensional ultrasound,and 98.6%and 83.3%for the combination of the two,indicating a high value of joint diagnosis.Conclusion The combination of 2D and 3D has a high diagnostic value for the sequence of deencephalopathy and anencephaly in fetuses at 11~14 weeks of gestation,with low misdiagnosis rate and missed diagnosis rate,and plays an important role in the scree

关 键 词：露脑畸形 无脑畸形 超声检查 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.5[医药卫生—临床医学]