胎儿颈项透明层厚度超声检查结合孕中期四维彩超筛查胎儿先天畸形的临床意义  

Clinical Significance of Fetal Nuchal Translucency Thickness Ultrasonography Combined with Midtrimester 4D Ultrasound for Screening Fetal Congenital Malformations

作　　者：汤雪苗 TANG Xue-miao(Chaozhou Maternal and Child Health Hospi-tal,Chaozhou,Guangdong,521000,China)

机构地区：[1]潮州市妇幼保健院,广东潮州521000

出　　处：《黑龙江医学》2022年第23期2864-2866,共3页Heilongjiang Medical Journal

摘　　要：目的:分析胎儿颈项透明层厚度超声(NT)检查结合孕中期四维彩超筛查胎儿先天畸形的临床意义。方法:选取2018年6月—2020年12月潮州市妇幼保健院胎儿先天畸形孕妇76例,并以1∶1配比选取同期胎儿发育正常孕妇76例。均行NT检查和孕中期四维彩超筛查,统计二者单独诊断和联合诊断胎儿先天畸形的诊断结果,对比NT检查、孕中期四维彩超筛查单独诊断和联合诊断的诊断效能(灵敏度、特异度、准确度、漏诊率、误诊率)和诊断预测值(阳性预测值、阴性预测值)。结果:76例先天畸形胎儿和76例发育正常胎儿中,采用NT检查诊断出真阳性64例,真阴性75例;采用孕中期四维彩超诊断出真阳性69例,真阴性74例;采用二者联合诊断出真阳性75例,真阴性74例。NT检查联合孕中期四维彩超诊断胎儿畸形,诊断特异度97.37%(74/76)、误诊率2.63%(2/76),与NT检查的98.68%(75/76)、1.32%(1/76)和孕中期四维彩超检查97.37%(74/76)、2.63%(2/76)对比,差异无统计学意义(P>0.05);NT检查联合孕中期四维彩超诊断灵敏度[98.68%(75/76)]较NT检查[84.21%(64/76)]、孕中期四维彩超[90.79%(69/76)]高,准确度[98.03%(149/152)]较NT检查[91.45%(139/152)]高,漏诊率[1.32%(1/76)]较NT检查[15.79%(12/76)]、孕中期四维彩超[9.21%(7/76)]低,差异有统计学意义(χ^(2)=9.975、0.409、6.433、9.975、0.409,P<0.05)。NT检查联合孕中期四维彩超诊断阳性预测值为97.40%(75/77),NT检查阳性预测值为98.46%(64/65),孕中期四维彩超为97.18%(69/71);NT检查联合孕中期四维彩超诊断阴性预测值为98.67%(74/75),高于NT检查的86.21%(75/87)和孕中期四维彩超检查的91.36%(74/81),差异有统计学意义(χ^(2)=0.275、8.306,P<0.05)。结论:NT检查结合孕中期四维彩超筛查胎儿先天畸形,可提高诊断灵敏度、准确度、阴性预测值,并能降低漏诊率,能为临床诊断提供更多影像学信息支持。Objective:To analyze the clinical significance of fetal nuchal translucency thickness ultrasonography(NT) in combination with midtrimester 4D ultrasound screening for fetal congenital malformations.Methods:76 pregnant women with fetal congenital malformations in hospitals from June 2018 to December 2020 were selected, and 76 pregnant women with normal fetal development in the same period were selected in a 1:1 matching ratio. All pregnant women were screened with NT and mid-pregnancy 4D ultrasound. The diagnostic results of both alone and combined diagnosis of fetal congenital malformations were counted, and the diagnostic efficacy(sensitivity, specificity, accuracy, leakage rate, misdiagnosis rate) and diagnostic predictive value(positive predictive value, negative predictive value) of NT test and midtrimester 4D ultrasound screening alone and combined diagnosis were compared.Results:Among 76 fetuses with congenital malformations and 76 fetuses with normal development, 64 true-positive cases and 75 true-negative cases were diagnosed by NT examination, 69 true-positive cases and 74 true-negative cases were diagnosed by mid-pregnancy 4D ultrasound, and 75 true-positive cases and 74 true-negative cases were diagnosed by the combination of both. There was no statistically significant difference in the diagnostic specificity and misdiagnosis rate of NT test combined with midtrimester 4D ultrasound for the diagnosis of fetal malformations compared with NT test and midtrimester 4D ultrasound(P>0.05). The diagnostic sensitivity of NT examination combined with mid-pregnancy 4D ultrasound was higher than that of NT examination and mid-pregnancy 4D ultrasound, the accuracy was higher than that of NT examination, and the rate of missed diagnosis was lower than that of NT examination and mid-pregnancy 4D ultrasound, and the difference was statistically significant(χ^(2)=9.975, 0.409, 6.433, 9.975, 0.409, P<0.05). The negative predictive value of NT test combined with midtrimester 4D ultrasound diagnosis was higher than that

关 键 词：胎儿先天畸形 胎儿颈项透明层厚度超声检查 孕中期四维彩超筛查 诊断效能 

分 类 号：R445.1[医药卫生—影像医学与核医学]