超声对双胎贫血多血质序列征的预测价值  

Predictive Value of Ultrasound for Twin Anemia-Polycythemia Sequence

作　　者：杜星星 刘俊 梁喜 王巧云 王云芙 Du Xingxing;Liu Jun;Liang Xi;Wang Qiaoyun;Wang Yunfu(Department of Ultrasound,The Affiliated Wuxi Matermity and Child Healthcare Hospital of Nanjing Medical University,Wuxi,Jiangsu 214002,China)

机构地区：[1]南京医科大学附属无锡妇幼保健院超声科,江苏省无锡市214002

出　　处：《中国超声医学杂志》2022年第2期238-240,共3页Chinese Journal of Ultrasound in Medicine

基　　金：2020年无锡市卫生健康委妇幼健康适宜技术推广项目(No.FYTG202001)。

摘　　要：目的探讨大脑中动脉峰值流速(MCA-PSV)及胎盘预测双胎贫血多血质序列征(TAPS)的价值。方法回顾性研究单绒毛膜双羊膜囊(MCDA)双胎的临床资料。产前1周内测量胎儿MCA-PSV,观察胎盘厚度和回声。产后12 h内测量新生儿血红蛋白(Hb)的含量及网织红细胞计数。结果①MCDA双胎间大脑中动脉峰值流速中位数倍数的差值(ΔMCA-PSV MoM)和血红蛋白的差值(ΔHB)具有正相关关系,相关系数为r=0.789(P<0.001)。②ΔMCA-PSV MoM预测TAPS的受试者工作特征(ROC)曲线下面积(AUC)为0.981,其截断值为0.466时,预测TAPS的灵敏度为100%,特异度为95.88%。③产前发现6例胎盘厚度和回声有明显差异,产后均被证实为TAPS。结论MCDA双胎间ΔMCA-PSV MoM能较好地预测TAPS,胎盘厚度和回声间的差异是TAPS的重要征象。Objective To explore the predictive value of the peak velocity of the middle cerebral artery(MCA-PSV)and the placenta in the diagnosis of twin anemia-polycythemia sequence(TAPS).Methods A retrospective study of the clinical data of monochorionic diamniotic(MCDA)twins.All pregnancies with measurements of MCA-PSV within one week before delivery were included.And we also observed the difference in thickness and echo between the placenta in two fetuses.Neonatal hemoglobin(Hb)concentrations and reticulocyte count were available within 12 hours after delivery.Results①There was a positive correlation between the inter-twin MCA-PSV MoM differences(ΔMCA-PSV MoM)and the neonatal inter-twin Hb differences(ΔHB)(r=0.789,P<0.001).②ΔMCA-PSV MoM between twins in the first week before delivery predicts the area under curve(AUC)of TAPS to be 0.981.When the cutoff value was 0.466,the sensitivity of the predicted TAPS was 100%and the specificity was 95.88%.③Placenta thickness and echo in six cases of MCDA with twin placental were found to be significantly different before delivery,and were confirmed as TAPS after delivery.ConclusionsΔMCA-PSV MoM between MCDA twins can better predict TAPS.MCDA twin placental thickness and echo are significantly different is an important sign of TAPS.

关 键 词：产前 大脑中动脉 双胎 

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]