胎儿颅脑生物学指标测量对三体综合征的诊断价值研究  

Study on the Diagnostic Value of Fetal Craniocerebral Biological Indicators in Trisomy Syndrome

作　　者：么海亮 胡蓉[1] 刘慧[1] 冯玉玲[1] 曾倩倩[1] 向红[1] Yao Hailiang;Hu Rong;Liu Hui;Feng Yuling;Zeng Qianqian;Xiang Hong(Department of Obstetrics and Gynecology Ultrasound,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Key Laboratory of Ultrasound Medicine,Wulumuqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院妇产超声诊断科,新疆超声医学重点实验室,乌鲁木齐市830054

出　　处：《中国超声医学杂志》2022年第6期673-676,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨透明隔腔宽径(CSP)/枕额径(OFD)比值产前预测三体综合征的诊断价值,论证已有研究CSP/小脑前后径(APCD)、APCD/小脑横径(TCD)比值诊断三体综合征的诊断价值。方法回顾性收集了孕19~24周三倍体胎儿的影像资料,分为18三体组及21三体组,以整倍体胎儿为对照组。测量CSP、OFD、TCD、APCD,计算CSP/OFD、CSP/APCD和APCD/TCD比值,进行组间比较并分析3个比值预测三体胎儿的诊断价值。结果共纳入整倍体胎儿500例,18三体胎儿27例,21三体胎儿68例。18三体组、21三体组和整倍体组的3个比值均值差异均有统计学意义(P<0.05);受试者工作特征曲线(ROC)分析CSP/OFD预测18三体时曲线下面积(AUC)为0.928,比值为0.074时诊断18三体的灵敏度(81.5%)和特异度(92.2%)最佳。预测21三体时AUC为0.720,比值为0.072时对诊断21三体的灵敏度(44.1%)和特异度(89.4%)最佳。结论CSP/OFD比值增大对预测胎儿18三体综合征和21三体综合征有一定价值,其预测性能与CSP/APCD相当,高于APCD/TCD。Objective To explore the diagnostic value of the ratio of cavum septi pellucidi width to occipito-frontal diameter(CSP/OFD)in the prenatal prediction of trisomy syndrome,and to demonstrate the diagnostic value of the ratio of CSP to anterior-posterior cerebellar diameter(APCD)and APCD to transverse cerebellar diameter(TCD).Methods The imaging data of triploid fetuses from 19 to 24 weeks of gestation were retrospectively collected and divided into trisomy 18 group and trisomy 21 group.Euploid fetuses were enrolled as control group.CSP,OFD,TCD and APCD were measured,CSP/OFD,CSP/APCD and APCD/TCD ratios were calculated,and the diagnostic value of the three ratios in predicting trisomy fetus was analyzed.Results A total of 500 euploidy fetuses,27 trisomy 18 fetuses and 68 trisomy 21 fetuses were included.The mean values between the three ratios of trisomy 18 group,trisomy 21 group and euploid group were significantly difference(P<0.05).The area under curve(AUC)of CSP/OFD for trisomy 18 was 0.928,and the sensitivity(81.5%)and specificity(92.2%)were the best when the ratio was 0.074.The AUC of trisomy 21 was 0.720,and the sensitivity(44.1%)and specificity(89.4%)were the best when the ratio was 0.072.Conclusions The increased CSP/OFD ratio has certain value in predicting fetal trisomy 18 syndrome and trisomy 21 syndrome,and its predictive performance is comparable to that of CSP/APCD,but higher than that of APCD/TCD.

关 键 词：超声 胎儿 18三体 21三体 透明隔腔 枕额径 

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]