核磁共振联合超声筛查胎儿颅脑结构的技术价值研究  

Study on the technical value of MR combined with ultrasound in screening the brain structure of fetus

作　　者：李鑫 李光 李素荣[1] 石莉丽 刘振宇 韩蕊娜[3] 李光民[1] LIXin;LI Guang;LI Su-rong(Department of Radiology,Tangshan Maternal and Child Health Care Hospital,Tangshan 063000,China.;不详)

机构地区：[1]唐山市妇幼保健院放射科,河北唐山063000 [2]唐山市妇幼保健院超声科,河北唐山063000 [3]唐山职业技术学院,河北唐山063000

出　　处：《中国医学装备》2022年第11期89-92,共4页China Medical Equipment

基　　金：河北省2021年度医学科学研究课题计划(20211667)“超声自由解剖成像技术与MRI对胎儿颅脑畸形诊断对比研究”。

摘　　要：目的:探讨超声联合磁共振成像(MRI)筛查胎儿颅脑组织结构异常的技术价值。方法:选取在保健院进行常规产前超声检查发现胎儿颅脑结构异常的2700例孕妇,对其进行彩超联合MRI检查,以产后MRI复查结果为标准,评估超声联合MRI筛查胎儿颅脑畸形的可靠性。结果:在2700例孕妇的孕检中共筛查出172例胎儿颅脑组织结构异常,包括侧脑室扩张、Dandy-Walker畸形、后颅凹池增宽、透明隔腔消失、脑膨出畸形、胼胝体发育不良、全前脑、小头畸形和Galen静脉血管瘤8项异常结果,且均经产后随访证实。产前MRI联合超声诊断胎儿颅脑结构异常的灵敏度、特异度和准确率分别为98.51%、86.84%和98.84%,高于单独进行超声检查的94.78%、50.0%和84.88%,并高于单独进行MRI检查的96.27%、68.42%和90.12%;3种检查方式的特异度和准确率差异均有统计学意义(χ^(2)=53.395,χ^(2)=21.473;P<0.01),灵敏度相比较,差异无统计学意义(χ^(2)=3.108,P>0.05)。结论:MRI与超声筛查胎儿颅脑结构各有优势和局限,联合应用可以实现技术价值最大化,有利于发现出生缺陷,提高优生率,最大限度地降低妊娠风险。Objective:To explore the technical value of ultrasound combined with magnetic resonance imaging(MRI)in screening abnormal structure of fetal brain tissue.Methods:A total of 2,700 pregnant women,whose fetuses existed abnormal brain structures that were confirmed by routine ultrasonic examination pre delivery,were selected.All of them underwent color Doppler ultrasound combined with MRI.The results of postpartum MRI reexamination was used as standard to assess the reliability of ultrasound combined with MRI in screening craniocerebral malformation of fetus.Results:A total of 172 fetuses with abnormal structure of brain tissue were screened in the pregnancy tests of 2,700 pregnant women,which included eight abnormal results:dilatation of the lateral ventricles,Dandy-Walker malformation,widening of the posterior fossa cisterns,disappearance of the septum pellucidum,encephalocele malformation,dysplasia of the corpus callosum,holoprosencephaly,microcephaly and Galen's vein hemangioma.All of them were confirmed by postpartum follow-up.The sensitivity,specificity and accuracy of prenatal MRI combined with ultrasound were respectively 98.51%,86.84%and 98.84%in the diagnosis of structural abnormalities of fetal brain,which were higher than 94.78%,50.0%and 84.88%of single ultrasound examination,and higher than 96.27%,68.42%and 90.12%of single MRI examination,and the differences of specificity and accuracy among them were significant(χ^(2)=53.395,χ^(2)=21.473,P<0.01),and there was no significant difference in sensitivity among the three groups(χ^(2)=3.108,P>0.05).Conclusion:MRI and ultrasound have respectively their own advantages and limitations in screening fetal brain structure.The combined application of them can maximize the technical value,which would help to find birth defects of newborns,and increase the eugenic rate,and farthest reduce the risk of pregnancy.

关 键 词：超声 磁共振成像(MRI) 胎儿 脑组织结构畸形 中枢神经系统异常 

分 类 号：R445.2[医药卫生—影像医学与核医学]