磁共振测量骨盆及胎头截面指数预测相对头盆不称的临床研究  

Clinical study of MRI measurement of pelvic and fetal head cross-section index in predicting relative cephalopelvic disproportion

作　　者：莫芸 方向明 王凌燕 MO Yun;FANG Xiangming;WANG Lingyan(Huzhou Maternal and Child Health Hospital,Zhejiang Huzhou 313000,China)

机构地区：[1]湖州市妇幼保健院,浙江湖州313000

出　　处：《中国妇幼健康研究》2021年第3期386-390,共5页Chinese Journal of Woman and Child Health Research

基　　金：湖州市科学技术研究计划公益项目(2018GYB69)。

摘　　要：目的探讨磁共振(MRI)测量骨盆及胎头截面指数对临床预测相对头盆不称的价值,为提高相对头盆不称产前评估准确率和选择合适分娩方式提供参考。方法选取2019年1月至2020年4月于湖州市妇幼保健院产科就诊并住院分娩的106例孕产妇为研究对象,筛除因与骨盆因素无关原因而行剖宫产术的11例孕产妇,其余95名孕产妇根据分娩结局分为阴道分娩组(63例)和剖宫产组(32例)。采用MRI测量孕产妇的骨盆及胎头参数,分析比较两组孕产妇的截面指数;依据MRI测量孕产妇骨盆及胎头截面指数分界标准,探讨不同截面指数对相对头盆不称的预测价值。结果剖宫产组孕产妇的骨盆及胎头截面指数均明显大于阴道分娩组,差异有统计学意义(t值分别为11.72,21.10,15.79,14.67,P均<0.01);依据MRI测量孕产妇骨盆及胎头截面指数分界标准,截面指数双肩径截面面积/骨盆出口前后三角平面面积之和的比值对相对头盆不称预测的灵敏度最高(31.25%),枕下前囟径截面面积/中骨盆平面面积比值的特异度(100%)和阳性预测符合率(100%)最高;而双顶径截面面积/骨盆入口平面面积比值和枕下前囟径截面面积/中骨盆平面面积比值对相对头盆不称预测的准确性较高(71.58%)。结论应用磁共振测量孕产妇骨盆及胎头截面指数,可相对客观预测相对头盆不称,为临床选择正确的分娩方式提供参考。Objective To investigate the value of magnetic resonance imaging(MRI)measurement of pelvic and fetal head cross-section index in clinical prediction of relative cephalopelvic disproportion,so as to provide reference for improving the accuracy of prenatal evaluation for relative cephalopelvic disproportion and selecting appropriate delivery mode.Methods From January 2019 to April 2020,the 106 cases of pregnant who were admitted and delivered in the obstetrics department of Huzhou Maternal and Child Health Hospital were selected as the research objects.After screening out 11 cases of pregnant who underwent cesarean section for reasons unrelated to pelvic factors,the remaining 95 puerperae were divided into vaginal delivery group(63 cases)and cesarean section group(32 cases)according to the delivery modes.MRI was used to measure the pelvic and fetal head parameters,and the cross-sectional indexes of the two groups were analyzed and compared.The predictive value of different cross-sectional indexes on relative cephalopelvic disproportion was discussed according to the dividing standard of MRI measurement of pelvic and fetal head cross-sectional indexes of pregnant women.Results The section index of pelvis and fetal head in cesarean section group were significantly higher than those in vaginal delivery group(t=11.72,21.10,15.79 and 14.67,respectively,all P<0.01).According to the demarcation standards of MRI measurement of the cross-section index of pelvis and fetal head,the ratio of the cross-section index of shoulder diameter to the sum of the area of anterior and posterior triangular plane of pelvic outlet had the highest sensitivity for the prediction of relative cephalopelvic disproportion(31.25%),while the specificity(100%)and positive predictive coincidence rate(100%)of the ratio of suboccipital anterior fontanel diameter cross-sectional area to median pelvic plane area were the highest.The ratio of biparietal diameter cross-sectional area to pelvic entrance plane area and the ratio of suboccipital anterior font

关 键 词：磁共振 骨盆及胎头截面指数 头盆不称 预测价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]