超声筛查胎儿先天性结构畸形的临床价值  

Clinical value of ultrasonography in screening fetal congenital structural malformations

作　　者：尹淑红 王晶晶[1] 吴青青[1] YIN Shuhong;WANG Jingjing;WU Qingqing(Department of Ultrasound.Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Bejjing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院超声科,北京市100026

出　　处：《临床超声医学杂志》2021年第5期393-395,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声筛查胎儿先天性结构畸形的临床价值。方法回顾分析我院和北京市各区县妇幼保健院10 133例均有出生结局的病例资料,分析超声筛查不同结构畸形阳性率情况,以及不同时期超声筛查阳性率。结果 10 133例病例中,共发现先天性出生缺陷214例(复合畸形16例),共230项畸形,其中产前超声检出胎儿结构性畸形92例(95项),检出率0.91%,产后超声诊断31例(50项),超声共诊断畸形123例,检出率1.21%,超声误诊13例,误诊率0.13%;超声漏诊结构畸形120例,漏诊率1.18%;对致命性结构畸形诊断准确率100%。超声筛查先天性结构畸形的准确率、敏感性、特异性分别为90.44%、61.19%、99.87%。早孕、中孕和晚孕期产前超声对胎儿畸形的检出率分别为2.17%、69.57%、28.26%,以孕中期胎儿畸形检出率最高(P<0.05)。结论超声是筛查先天性结构畸形直接而有效的方法,尤其在中孕期检出率最高,但存在漏诊非致命的结构异常。ObjectiveTo investigate the value of ultrasound in screening fetal congenital structural malformations.MethodsThe clinical data of 10 133 parturients with birth outcomes in Beijing Obstetrics and Gynecology Hospital and other Maternal and Child Health Hospital in different districts of Beijing were retrospectively analyzed.The positive rates of different structural malformations screened by ultrasound and the positive rates of different pregnancy stage were analyzed.ResultsAmong the 10 133 cases,a total of 214 cases of congenital birth defects(16 cases of complex malformations)were found,and a total of 230 malformations were found.Among these,totally 92 cases(95 deformities) of fetal structural malformations were detected by prenatal ultrasound screening,with a detection rate of 0.91%,and 31 cases(50 deformities)of postnatal ultrasound were diagnosed,with a detection rate of 1.21%(123 cases).A total of 13 cases were misdiagnosed by ultrasound,with a misdiagnosis rate of 0.13%.Totally 120 cases of structural malformations were misdiagnosed by ultrasound,with a misdiagnosis rate of 1.18%.The diagnostic accuracy of life-threatening fetal structural malformations was100%.The accuracy,sensitivity and specificity of ultrasound in screening congenital structural malformations were 90.44%,61.19%and 99.87%,respectively.The detection rate of fetal malformation in early pregnancy,middle pregnancy and late pregnancy was 2.17%,69.57%and 28.26%,respectively,with the highest detection rate in the middle pregnancy(P<0.05).ConclusionUltrasound is a direct and effective method for the screening of congenital structural malformations,especially in the middle pregnancy with the highest detection rate.However,several non-life-threatening fetal structural abnormalities are missed diagnosis.

关 键 词：超声检查 先天性结构畸形 胎儿 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.53[医药卫生—诊断学]