三维超声、磁共振及血清甲胎蛋白用于产前诊断胎儿脊柱裂价值  

Diagnostic value of prenatal three-dimensional ultrasound,magnetic resonance imaging,and serum AFP level for fetal spina bifida

作　　者：牛娜 王明玥 NIU Na;WANG Mingyue(Suzhou Hospital of Integrated Traditional Chinese and Western Medicine,Suzhou,Jiangsu Province,215101;The First Affiliated Hospital of Soochow University,Suzhou)

机构地区：[1]江苏省苏州市中西医结合医院,215101 [2]苏州大学附属第一医院

出　　处：《中国计划生育学杂志》2022年第4期940-943,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨产前三维超声、磁共振(MRI)及血清甲胎蛋白(AFP)对胎儿脊柱裂的诊断价值。方法:回顾性分析2016年3月-2021年3月本院产前检查疑似存在胎儿脊柱裂孕妇135例临床资料,均行血清AFP、MRI、三维超声检查。比较诊断准确率并用ROC曲线预测诊断效能。结果:经引产或分娩证实,135例疑似胎儿脊柱裂者检出畸形114例,准确率AFP 76.3%,MRI 88.2%,三维超声83.0%,3项联合98.5%。ROC曲线分析显示,预测胎儿脊柱裂的AUC三维超声为0.821,MRI为0.872,AFP为0.724,3项联合为0.972。结论:在产前检查中预测胎儿脊柱裂时,血清AFP、MRI、三维超声联合检测,能够提高诊断准确率。Objective:To explore the diagnostic value of prenatal three-dimensional ultrasound,magnetic resonance imaging(MRI),and serum alpha-fetoprotein(AFP)level for fetal spina bifida.Methods:Retrospective analysis was conducted on 135pregnant women with suspected fetal spina bifida from March 2016to March 2021.The serum AFP level of these women was detected,and the examinations of MRI and three-dimensional ultrasound of these women were also performed,and which diagnostic accuracy rate was compared.Receiver operating characteristic(ROC)curve was used to predict the diagnostic efficacy of the serum AFP level,and the results of MRI and three-dimensional ultrasound examinations for fetal spina bifida.Results:114fetuses with spina bifida were confirmed by induced labor or delivery in 135women with suspected fetal spina bifida.The diagnostic accuracy rate of the serum AFP level,and the result of MRI or three-dimensional ultrasound,and the combined of the serum AFP level and the results of MRI and three-dimensional ultrasound for fetal spina bifida were 76.3%,88.2%,83.0%,and 98.5%,respectively.ROC curve analysis showed that the AUC of the serum AFP level,and the result of MRI or three-dimensional ultrasound,and the combined of the serum AFP level and the results of MRI and three-dimensional ultrasound for predicting fetal spina bifida were 0.872,0.724,and 0.972,respectively.Conclusion:The combination of the serum AFP level and the results of MRI and three-dimensional ultrasound for fetal spina bifida can improve the accuracy of diagnosis.

关 键 词：产前诊断 神经管畸形 胎儿脊柱裂 三维超声 磁共振 甲胎蛋白 诊断效能 

分 类 号：R714.5[医药卫生—妇产科学]