二维结合四维超声在胎儿脊柱异常中的诊断价值及胎儿脊柱3D打印在四维彩超中的初步应用  

Diagnostic value of two-dimensional combined with four-dimensional ultrasound in fetal spinal abnormalities and the preliminary application of three-dimensional printing of fetal spine in four-dimensional color ultrasound

作　　者：刘海兰[1] 宋嫣[1] 王豪 张志平[2] 汪晨 陈颖慧 LIU Hailan;SONG Yan;WANG Hao;ZHANG Zhiping;WANG Chen;CHEN Yinghui(Department of Ultrasound,Nanchang First Hospital,Jiangxi Province,Nanchang330006,China;Department of Spinal Surgery,Nanchang First Hospital,Jiangxi Province,Nanchang330006,China)

机构地区：[1]南昌市第一医院超声科,江西南昌330006 [2]南昌市第一医院脊柱外科,江西南昌330006

出　　处：《中国当代医药》2022年第34期51-54,共4页China Modern Medicine

基　　金：江西省教育厅课题(GJJ180111)。

摘　　要：目的分析二维、二维结合四维超声在胎儿脊柱异常的诊断率,探讨以四维超声为数据源,采用3D打印技术制作胎儿脊柱模型的可行性。方法回顾性分析2018年1月至2021年12月于南昌市第一医院接受四维彩超检查的125例孕妇的四维彩超胎儿脊柱影像学资料,孕妇年龄(28.66±2.67)岁,孕龄(24.45±0.78)周,比较分析二维、二维与四维相结合超声的图像资料,得出诊断结果;选取质量较好的脊柱裂图像,测量各维度径线,以3D容积DICOM格式储存并通过软件处理转变STL文件,使用塑料材料聚乳酸熔融沉积成型制作脊柱3D模型。结果125例四维彩超胎儿中,脊柱正常104例,异常有21例,其中半椎体10例、蝴蝶椎6例、胸椎融合椎4例、尾椎脊柱裂1例。二维结合四维超声诊断脊柱异常的灵敏度高于二维超声,漏诊率低于二维超声,差异有统计学意义(P<0.05);二维结合四维超声和二维超声的特异度、准确率、误诊率比较,差异无统计学意义(P>0.05)。以四维彩超脊柱容积图像作为数据源,可以进行胎儿脊柱3D模型打印。结论二维与四维彩超对胎儿脊柱异常的诊断率明显提高,采用四维彩超结合3D打印技术制作胎儿脊柱模型可行。Objective To analyze the diagnostic rate of two-dimensional(2D)and 2D combined with four-dimensional ultrasound(4D-US)in fetal spinal abnormalities,and to explore the feasibility of using three-dimensional(3D)printing technology to make fetal spinal model with 4D-US as data source.Methods The 4D-US fetal spinal imaging data of 125 pregnant women who received 4D-US examination in Nanchang First Hospital from January 2018 to December 2021 were regression analyzed,and the age of the pregnant woman was(28.66±2.67)years old and the gestational week was(24.45±0.78)weeks.The 2D,2D combined with 4D-US image data were compared and analyzed,and the diagnostic results were obtained.Normal fetal spine with good image quality was selected,diameter lines of each dimension were measured,STL files were stored in 3D volumetric DICOM format and transformed through software processing,and 3D spinal model was made by melt deposition of plastic material polylactic acid.Results Among 125 fetuses with 4D-US,104 fetuses had normal spine.There were 21 abnormal cases,included 10 cases of hemivertebrae,6 cases of butterfly vertebrae,4 cases of thoracic fusion vertebrae and 1 case of caudal spina bifida.The sensitivity of 2D combined with 4D-US in the diagnosis of spinal abnormalities was higher than that of 2D-US,and the missed diagnosis rate of 2D combined with 4D-US was lower than that of 2D-US,and the differences were statistically significant(P<0.05).There were no significant difference in the specificity,accuracy and misdiagnosis rate between 2D combined with 4D-US and 2D-US(P>0.05).The 3D model of fetal spine could be printed by used 4D color ultrasound image of spine volume as data source.Conclusion The diagnosis rate of fetal spinal abnormalities by 2D combined with 4D color Doppler ultrasound is significantly increased.It is feasible to use 4D-US combined with 3D printing technology to make fetal spine model.

关 键 词：胎儿脊柱 3D打印 四维彩超 二维超声 

分 类 号：R726.8[医药卫生—儿科]