产前超声检查诊断胎儿畸形价值分析  

Value analysis of prenatal ultrasound in diagnosis of fetal malformation

作　　者：马格 MA Ge(Ultrasound Department,Gaizhou Third People’s Hospital,Gaizhou 115206,China)

机构地区：[1]辽宁省盖州第三人民医院超声科,115206

出　　处：《中国实用医药》2022年第5期80-82,共3页China Practical Medicine

摘　　要：目的 探讨产前超声检查诊断胎儿畸形的临床价值。方法 常规开展孕期保健的产妇2950例,产前均二维、二维+三维超声检查,统计分析产前超声诊断胎儿畸形部位及孕周分布情况,以病理筛查为金标准,分析比较二维、二维+三维超声筛查结果的灵敏度、特异度、阳性预测值、阴性预测值。结果 2950例孕妇经超声检出21例畸形,占0.71%。孕周18-24周胎儿畸形的占比最高,为61.9%,其次分别为11-18周的23.8%, 30-32周的9.5%, 37-41周的4.8%。2950例中共有352例接受随访,均开展病理和新生儿畸形筛查,阳性23例,阴性329例。以病理和新生儿畸形筛查结果为金标准,二维超声筛查畸形灵敏度为47.8%,特异度99.7%,阳性预测值为91.7%,阴性预测值为96.5%;二维+三维超声筛查畸形灵敏度为82.6%,特异度99.4%,阳性预测值为90.5%,阴性预测值为98.8%。二维+三维超声筛查畸形灵敏度高于二维超声,差异具有统计学意义(χ^(2)=6.133, P=0.013<0.05)。结论 产前超声检查诊断胎儿畸形的临床价值较高,相较于二维超声,二维联合三维超声的检测灵敏度更高。Objective To discuss the clinical value of prenatal ultrasound in diagnosis of fetal malformation.Methods 2950 cases of pregnant women who routinely carry out health care during pregnancy received two-dimensional,two-dimensional combined with three-dimensional ultrasound examinations before delivery,and the distribution of fetal malformation sites and gestational weeks were statistically analyzed.The sensitivity,specificity,positive predictive value and negative predictive value of two-dimensional,twodimensional combined with three-dimensional ultrasound were analyzed and compared using pathological screening as the gold standard.Results 21 cases of malformations were detected in 2950 pregnant women after ultrasound examination,accounting for 0.71%.The proportion fetal malformations at 18-24 weeks of gestation was the highest at 61.9%,followed by 23.8%at 11-18 weeks,9.5%at 30-32 weeks,and 4.8%at 37-41 weeks,respectively.A total of 352 of 2950 cases were followed up,all of which were screened for pathology and neonatal malformations,with 23 positive cases and 329 negative cases.Using pathology and neonatal malformation screening results as the gold standard,two-dimensional for malformations had a sensitivity of 47.8%,a specificity of 99.7%,a positive predictive value of 91.7%,and a negative predictive value of 96.5%.Two-dimensional combined with three-dimensional ultrasound for malformations had a sensitivity of 82.6%,a specificity of 99.4%,a positive predictive value of 90.5%,and a negative predictive value of 98.8%.The sensitivity of two-dimensional combined with three-dimensional ultrasound for malformations was higher than that of twodimensional ultrasound,and the difference was statistically significant(χ^(2)=6.133,P=0.013<0.05).Conclusion Prenatal ultrasound has a high clinical value in the diagnosis of fetal malformation,and the sensitivity of twodimensional ultrasound combined with three-dimensional ultrasound is higher than that of two-dimensional ultrasound alone.

关 键 词：产前超声检查 胎儿畸形 二维超声 三维超声 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]