二维超声联合四维超声诊断在胎儿颜面部畸形排查中的诊断价值  

Diagnostic value of two-dimensional ultrasound combined with four-dimensional ultrasound in the diagnosis of fetal facial deformities

作　　者：韩玉娜 谢靖红[2] 王冬梅[3] HAN Yu-na;XIE Jing-hong;WANG Dong-mei(Department of Obstetrics and Gynecology,Qingdao Women's and Children's Hospital,Qingdao Shandong 266000,China;Department of Radiology,Qingdao Eight People's Hospital,Qingdao Shandong 266100,China;Color Doppler Ultrasound Room,Department of Functional Examination,Qingdao Hospital of Traditional Chinese Medicine(Qingdao Haici Hospital),Qingdao Shandong 266400,China)

机构地区：[1]青岛市妇女儿童医院妇产超声科,山东青岛266000 [2]青岛市第八人民医院放射科,山东青岛266100 [3]青岛市中医医院(青岛市海慈医院)功能检查科彩超室,山东青岛266400

出　　处：《临床和实验医学杂志》2021年第16期1782-1786,共5页Journal of Clinical and Experimental Medicine

基　　金：山东省医药卫生科技发展计划资助项目(编号:2017WSA10302)。

摘　　要：目的研究胎儿颜面部畸形排查中二维超声联合四维超声的诊断价值。方法采用回顾性分析方法,以2017年6月至2020年6月青岛市妇女儿童医院收治的100例产前筛查胎儿疑似颜面部畸形孕妇为研究对象,根据不同诊断方式分为二维超声组(二维超声检查)与联合超声组(二维超声联合四维超声检查)。对比2组诊断准确率、灵敏度、特异度、漏诊率及误诊率。结果以分娩结果为金标准,100例产前筛查胎儿疑似颜面部畸形孕妇中,68例胎儿颜面部畸形,其中唇腭裂27例,唇裂15例,鼻骨发育不良7例,鼻泪管囊肿4例,眼发育不良3例,面横列3例,耳低置2例,耳发育异常2例,下颌偏短向内1例,鼻骨缺失1例,鼻前皮肤增厚1例,独眼1例,面部皮肤层增厚1例。而二维超声组诊断胎儿颜面部畸形的准确率、灵敏度、漏诊率依次为86.00%、82.35%、17.65%;联合超声组诊断胎儿颜面部畸形的准确率、灵敏度、漏诊率依次为99.00%、98.53%、1.47%,联合超声组较二维超声组诊断胎儿颜面部畸形的准确率、灵敏度更高,漏诊率更低,差异均有统计学意义(P<0.05)。联合超声组诊断特异度、误诊率分别为100.00%、0,二维超声组诊断胎儿颜面部畸形的特异度、误诊率分别为93.75%、6.25%;2组诊断特异度、误诊率差异无统计学意义(P>0.05)。结论胎儿颜面部畸形排查中二维超声联合四维超声诊断的效果明显优于单一二维超声,可进一步提升诊断准确率及灵敏度,还可减少漏诊。Objective To study the diagnostic value of two-dimensional ultrasound combined with four-dimensional ultrasound in the investigation of fetal facial deformities. Methods A retrospective analysis method was uesd,100 cases of prenatal screening of pregnant women with suspected facial deformities in Qingdao Women and Children’s Hospital from June 2017 to June 2020 were used as the research objects. According to different diagnosis methods,they were divided into two-dimensional ultrasound group(two-dimensional ultrasound examination) and combined ultrasound group(two-dimensional ultrasound combined with four-dimensional ultrasound examination),the diagnostic accuracy,sensitivity,specificity,missed diagnosis rate and misdiagnosis rate of the two groups were compared. Results Taking delivery results as the gold standard,out of 100 pregnant women with prenatal screening for suspected fetal facial abnormalities,68 cases of fetal facial abnormalities,including 27 cases of cleft lip and palate,15 cases of cleft lip,7 cases of nasal dysplasia,and nasolacrimal duct cyst 4 cases,3 cases of ocular dysplasia,3 cases of horizontal alignment,2 cases of ear dysplasia,2 cases of ear dysplasia,1 case of mandible short inward,1 case of nasal bone loss,1 case of anterior skin thickening,1 case of cyclops,1 case of facial skin thickening. The accuracy,sensitivity,and missed diagnosis rate of the two-dimensional ultrasound group in diagnosing fetal facial abnormalities were 86. 00%,82. 35%,and 17. 65%;the accuracy,sensitivity,and missed diagnosis rate of the combined ultrasound group in diagnosing fetal facial abnormalities were 99. 00%,98. 53% and 1. 47%. Compared with the two-dimensional ultrasound group,the combined ultrasound group had higher accuracy and sensitivity in diagnosing fetal facial deformities,and the missed diagnosis rate was lower. The differences were statistically significant(P<0.05). The diagnostic specificity and misdiagnosis rate of the combined ultrasound group were 100. 00% and 0,respectively. The two-dimensio

关 键 词：胎儿 颜面部畸形 二维超声 四维超声 联合检查 诊断价值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]