超声联合磁共振成像诊断单绒毛膜多胎妊娠畸形效果  

Application effect of ultrasound combined with magnetic resonance imaging for diagnosing monochorionic multiple pregnancy malformations

作　　者：马静[1] 霍飞霞 宋林琳 MA Jing;HUO Feixia;SONG Linlin(Nanyang Central Hospital,Nanyang,Henan Province,473000)

机构地区：[1]河南省南阳市中心医院,473000

出　　处：《中国计划生育学杂志》2023年第3期624-627,共4页Chinese Journal of Family Planning

摘　　要：目的:探究超声和磁共振成像(MRI)联合诊断单绒毛膜多胎妊娠畸形效果。方法:回顾性收集2017年1月-2021年9月本院收治疑为单绒毛膜多胎妊娠畸形的孕妇86例临床资料,均行超声和MRI,以分娩、引产或手术后结果为金标准,评估超声、MRI、超声联合MRI在单绒毛膜多胎妊娠畸形诊断中的应用效果。结果:86例中有28例诊断为单绒毛膜多胎妊娠畸形,超声、MRI、超声联合MEI与金标准在诊断单绒毛膜多胎妊娠畸形的Kappa分别为0.716、0.726、0.747。超声诊断单绒毛膜多胎妊娠畸形的敏感度75.0%,特异度89.7%,准确率84.9%,阳性预测77.8%,阴性预测88.1%;MRI诊断单绒毛膜多胎妊娠畸形的敏感度89.3%,特异度84.5%,准确率86.1%,阳性预测73.5%,阴性预测94.2%,超声联合MRI诊断单绒毛膜多胎妊娠畸形的敏感度92.9%,特异度84.5%,准确率为87.21%,阳性预测74.3%,阴性预测96.1%。结论:超声、MRI、超声联合MRI诊断单绒毛膜多胎妊娠畸形均有较好一致性,超声联合MRI诊断价值更更高,对于临床指导干预、采取有效措施、降低不良妊娠率具有重要意义可提高畸形诊断的敏感度、阴性预测值。Objective:To explore the application effect of ultrasound combined with magnetic resonance imaging(MRI)for diagnosing monochorionic multiple pregnancy malformations.Methods:The clinical data of 86 pregnant women with suspected monochorionic multiple pregnancy malformations between January 2017 and September 2021 were collected retrospectively.These women had received ultrasound and MRI examinations.The results of delivery,odinopoeia,or surgery of the women were used as the gold standards,the application effect of ultrasound,MRI,and the ultra-sound combined with MRI for diagnosing the monochorionic multiple pregnaney malformations were evaluated.Results:28 of 86 pregnant women were diagnosed as monochorionie multiple pregnancy malformations.Based on the gold standard of diagnosis,the Kappa values of ultrasound,MRI,and ultrasound combined with MRI for diagnosing the monochorionic multiple pregnancy malformations were 0.716,0.726,and 0.747,respectively.The sensitivity,the specificity,the accuracy rate,the positive prediction value,and the negative prediction value of ultrasound for diagnosing monochorionic multiple pregnancy malformations were 75.0%,89.7%,84.9%,77.8%,and 88.1%,respectively,which of MRI for diagnosing monochorionic multiple pregnancy malformations were 89.3%,84.5%,86.1%,73.5%,and 94.2%,respectively,and which ultrasound combined with MRI for diagnosing the monochorionic multiple preg-nancy malformations were 92.9%,84.5%,87.21%,74.3%,and 96.1%,respectively.Conclusion:Ultrasound,MRI,and ultrasound combined with MRI for diagnosing the monochorionic multiple pregnancy malformations have the same good consistency.Ultrasound combined with MRI has better diagnostic value,which is of great significance for clinical intervention,taking effective measures,and reducing the rate of adverse pregnancy,with the increased sensitivity and negative predictive value of malformation diagnosis.

关 键 词：多胎妊娠 先天畸形 超声 磁共振成像 产前诊断 

分 类 号：R445[医药卫生—影像医学与核医学] R714.23[医药卫生—诊断学]