心脏纵隔移位角用于预测肺部肿块胎儿围产期不良结局  

Cardiomediastinal shift angle for predicting perinatal adverse outcomes of fetus with pulmonary mass

作　　者：德文洁 胡蓉[1] 周慧丽[1] 曾倩倩[1] DE Wenjie;HU Rong;ZHOU Huili;ZENG Qianqian(Department of Obstetrics and Gynecology Ultrasonic Diagnosis,Xinjiang Key Laboratory of Ultrasound Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,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,新疆乌鲁木齐830011

出　　处：《中国医学影像技术》2022年第8期1218-1222,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的评价心脏纵隔移位角(CMSA)用于预测肺部肿块胎儿围产期不良结局的价值。方法基于产前超声声像图测量并计算52胎肺部肿块胎儿的CMSA及其与先天性囊性腺瘤样畸形的体积比(CVR);比较不同结局及有、无水肿胎儿CMSA和CVR测值的差异。采用Spearman相关系数评价CMSA与CVR的相关性;绘制受试者工作特征曲线,计算曲线下面积(AUC),评价CMSA和CVR预测肺部肿块胎儿转归的效能,并以DeLong检验进行比较。结果不良结局胎儿的CMSA及CVR均大于结局良好者(P均<0.05)。水肿胎儿CMSA及CVR均大于无水肿者(P均<0.05)。CMSA与CVR呈正相关(r=0.78,P<0.05)。以CMSA、CVR预测胎儿不良结局的AUC分别为0.92及0.99,敏感度分别为82.00%及100%,特异度分别为90.00%及95.00%;二者效能差异无统计学意义(Z=1.54,P=0.13)。结论CMSA可用于预测肺部肿块胎儿围产期结局,其价值与CVR相当。Objective To observe the value of cardiomediastinal shift angle(CMSA)for predicting perinatal adverse outcomes in fetus with pulmonary mass.Methods Based on prenatal ultrasonography,CMSA and congenital cystic adenomatoid malformation volume ratio(CVR)of 52 fetuses with pulmonary mass were measured and calculated.Values of CMSA and CVR were compared between fetuses with different outcomes,also with or without edema.Spearman correlation coefficient was used to evaluate the correlation between CMSA and CVR.Receiver operating characteristic curves were drawn,and the areas under the curves(AUC)were calculated to evaluate the efficacy of CMSA and CVR for predicting the outcomes of fetus with pulmonary mass.DeLong test was used to compare the efficacies.Results CMSA and CVR were higher in fetuses with adverse outcomes than in those with good outcomes(both P<0.05),in fetuses with edema than in those without edema(both P<0.05).CMSA was positively correlated with CVR(r=0.78,P<0.05).AUC of CMSA and CVR for predicting fetal adverse outcomes was 0.92 and 0.99,the sensitivity was 82.00%and 100%,and the specificity was 90.00%and 95.00%,respectively,no significant difference of prediction efficacy was found between CMSA and CVR(Z=1.54,P=0.13).Conclusion CMSA could be used to predict the perinatal outcome of fetus with pulmonary mass,which had the same predictive value to CVR.

关 键 词：肺囊性腺瘤样畸形 先天性 支气管肺隔离症 心脏纵隔移位角 围产期 超声检查 

分 类 号：R714.53[医药卫生—妇产科学] R445.1[医药卫生—临床医学]