三维超声在胎儿脊髓和脊柱发育状况评估中的应用价值  

Application value of three dimensional ultrasound in evaluation of fetal spinal cord and spine

作　　者：石海梅 SHI Haimei(the People's Hospital of Zichang County,Yan'an 717300,China)

机构地区：[1]子长县人民医院,陕西延安717300

出　　处：《临床医学研究与实践》2021年第5期136-138,共3页Clinical Research and Practice

摘　　要：目的探讨三维超声在胎儿脊髓和脊柱发育状况评估中的应用价值。方法将2019年2月至2020年3月我院产科收诊的488例高危妊娠孕妇纳入研究,对孕妇实施三维超声检查。以妊娠终止后检查结果为诊断金标准,分析三维超声在胎儿脊髓和脊柱发育状况评估中的价值。结果三维超声对胎儿脊髓脊柱发育异常的诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为98.11%、99.31%、99.18%、94.55%、99.77%。三维超声对脊柱发育异常的诊断符合率为92.86%,对脊髓发育异常、脊柱脊髓复合畸形的诊断符合率均达到100.00%。三维超声的诊断结果与妊娠终止后检查结果之间具有高度一致性,Kappa值为0.754。胎儿脊髓脊柱发育异常组的颈膨大、腰膨大、胸窄处直径均大于胎儿脊髓脊柱发育正常组,差异具有统计学意义(P<0.05);胎儿颈膨大、腰膨大、胸窄处直径与脊髓脊柱发育异常(出现任意一种异常)呈正相关(r=0.835、0.840、0.819,P<0.05)。结论产前三维超声检查可对胎儿脊髓脊柱的发育状况进行准确评估,应用价值较高。Objective To investigate the application value of three dimensional ultrasound in evaluation of fetal spinal cord and spine.Methods A total of 488 high-risk pregnant women admitted in obstetrics department of our hospital from February 2019 to March 2020 were included in the study,and three dimensional ultrasound examination was carried out for the pregnant women.Taking the examination results after pregnancy termination as the gold standard,the application value of three dimensional ultrasound in evaluation of fetal spinal cord and spine was analyzed.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of three dimensional ultrasound in the diagnosis of fetal dysplasia of spinal cord and spine were 98.11%,99.31%,99.18%,94.55%and 99.77%,respectively.The coincidence rate of three dimensional ultrasound in the diagnosis of spinal cord dysplasia was 92.86%,and the coincidence rates in the diagnosis of spine dysplasia,spinal cord and spine complex malformation were 100.00%.There was a high degree of consistency between the diagnostic results of three dimensional ultrasound and the examination results after pregnancy termination,with Kappa value of 0.754.The diameters of cervical enlargement,lumbar enlargement and thoracic stenosis in the fetal dysplasia of spinal cord and spine group were larger than those in the fetal normal development of spinal cord and spine group,and the differences were statistically significant(P<0.05);there were positive correlations between the diameters of cervical enlargement,lumbar enlargement,thoracic stenosis and dysplasia of spinal cord and spine(r=0.835,0.840,0.819,P<0.05).Conclusion Prenatal three dimensional ultrasound test can accurately evaluate the development state of fetal spinal cord and spine,which has higher application value.

关 键 词：产前筛查 胎儿 脊髓脊柱发育异常 三维超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]