二维结合三维超声在早孕期胎儿唇腭裂畸形筛查诊断中的应用研究  

Application of Two-dimensional Combined with Three-dimensional Ultrasound in Screening and Diagnosis of Fetal Cleft Lip and Palate in Early Pregnancy

作　　者：程玲[1] 程芳玲[1] 吴牡丹[1] 任苓[1] 曾庆新[1] CHENG Ling;CHENG Fangling;WU Mudan;REN Ling;ZENG Qingxin(First Affiliated Hospital of Gannan Medical University,Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]赣南医学院第一附属医院,江西赣州341000

出　　处：《中国医学创新》2021年第36期162-166,共5页Medical Innovation of China

摘　　要：目的:探讨二维超声(two-dimensional ultrasonography,2DUS)结合三维超声(three-dimensional ultrasonography,3DUS)在早孕期胎儿唇腭裂(cleft lip/palate,CL/P)畸形筛查诊断中的应用研究。方法:选取2020年3月-2021年3月在赣南医学院第一附属医院行产前筛查的早孕期孕妇5260例。所有孕妇均常规接受二维超声及三维超声筛查;并将引产或分娩结果作为金标准。观察所有胎儿的超声筛查结果,比较2DUS、3DUS及2DUS联合3DUS筛查诊断CL/P的准确率、敏感度和特异度。结果:5260例孕妇共筛查5384例胎儿,引产或分娩证实共存在CL/P 31例(0.6%),其中,左侧19例,双侧6例,正中4例,不规则2例。2DUS筛查诊断CL/P真阳性15例,假阳性(误诊)10例,真阴性5343例,假阴性(漏诊)16例。3DUS筛查诊断CL/P真阳性26例,假阳性(误诊)6例,真阴性5347例,假阴性(漏诊)5例。2DUS联合3DUS筛查诊断CL/P真阳性31例,假阳性(误诊)1例,真阴性5352例,未出现假阴性(漏诊)。三种诊断方式的敏感度比较,差异有统计学意义(P<0.05),其中2DUS联合3DUS检查诊断CL/P的敏感度最高。结论:在早孕期CL/P畸形筛查及诊断过程中联合使用2DUS和3DUS,可显著提升敏感度,为临床医生提供更多的参考资料及依据。Objective:To investigate the application of two-dimensional ultrasound(2DUS)combined with three-dimensional ultrasound(3DUS)in the screening and diagnosis of cleft lip/palate(CL/P)malformations in early pregnancy.Method:A total of 5260 early pregnant women who underwent prenatal screening in First Affiliated Hospital of Gannan Medical University from March 2020 to March 2021 were selected.All pregnant women were routinely screened by two-dimensional ultrasound and three-dimensional ultrasound;the results of induced labor or delivery were used as the gold standard.The ultrasound screening results of all fetuses were observed,and the accuracy,sensitivity and specificity of 2DUS,3DUS and 2DUS combined with 3DUS screening for CL/P were compared.Result:Among 5260 pregnant women,5384 fetuses were screened,and 31 cases(0.6%)were confirmed to had CL/P by induced labor or delivery.Among them,left 19 cases,bilateral 6 cases,median 4 cases,irregular 2 cases.There were 15 CL/P true positives,10 false positives(misdiagnosis),5343 true negatives and 16 false negatives(missed diagnosis)by 2DUS screening.3DUS screening diagnosed 26 CL/P true positives,6 false positives(misdiagnosis),5347 true negatives,and 5 false negatives(missed diagnosis).2DUS combined with 3DUS screening diagnosed 31 CL/P true positive cases,1 false positive(misdiagnosis)cases,5352 true negative cases,no false negative cases(missed diagnosis).The sensitivity comparison of the three diagnostic methods showed statistically significant difference(P<0.05),and 2DUS combined with 3DUS showed the highest sensitivity in CL/P diagnosis.Conclusion:The combined use of 2DUS and 3DUS in the screening and diagnosis of CL/P malformation during early pregnancy can significantly improve sensitivity and provide more reference materials and basis for clinicians.

关 键 词：早孕期 唇腭裂 二维超声 三维超声 

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]