连续顺序追踪超声法诊断在早孕期胎儿严重肢体畸形的临床价值  

The Clinical Value of Continuous Sequential Tracking Ultrasound in the Diagnosis of Severe Fetal Limb Malformations in Early Pregnancy

作　　者：肖景盛 王育銮 XIAO Jing-sheng;WANG Yu-luan(Department of Ultrasound,Sanxiang Hospital of Zhongshan,Zhongshan,Guangdong,528463,China)

机构地区：[1]中山市三乡医院超声科,广东中山528463

出　　处：《黑龙江医学》2023年第12期1473-1475,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨连续顺序追踪超声法(SCSA)在早孕期胎儿严重肢体畸形中的诊断价值。方法:选取2019年4月—2021年3月中山市三乡医院行产检且查出疑似胎儿严重肢体畸形的96例早孕期孕妇作为研究对象,对所有孕妇分别行常规超声筛查与SCSA筛查。以引产结果为“金标准”,比较两种筛查方式在早孕期胎儿严重肢体畸形中的筛查情况与诊断效能。结果:96例疑似胎儿严重肢体畸形的孕妇经引产结果明确为胎儿严重肢体畸形有84例,检出率为87.50%;SC⁃SA检出符合率为96.42%,高于常规超声的85.71%,差异有统计学意义(χ^(2)=5.929,P<0.05)。SCSA在早孕期胎儿严重肢体畸形诊断中的灵敏度为95.24%、准确度为94.79%、阴性预测值为73.33%,均高于常规超声检查的80.95%、79.17%、33.33%,差异有统计学意义(χ^(2)=8.173、10.347、5.912,P<0.05);但两种方法特异度、阳性预测值相比,差异无统计学意义(χ^(2)=1.011、1.092,P>0.05)。Kappa检验显示:超声检查DTC患者淋巴结转移与“金标准”检查结果具有一致性(Kappa=0.785,P<0.001)。结论:SCSA具有高灵敏度、准确度,可作为早孕期筛查诊断胎儿严重肢体畸形的有效措施。Objective:To investigate the diagnostic value of continuous sequential tracking ultrasound(SCSA)in severe fetal limb malformations in early pregnancy.Methods:96 pregnant women in early pregnancy with suspected severe fetal limb anomalies detected in hospital obstetric examinations from April 2019 to March 2021 were selected for the study,and conventional ultrasound screening and SCSA screening were administered to all pregnant women.The screening status and diagnostic efficacy of the two screening modalities in early pregnancy for severe fetal limb anomalies were compared,using the result of induction of labor as the“gold standard”.Results:The results of 96 pregnant women with suspected severe fetal limb anomalies who were induced were clearly identified as having severe fetal limb anomalies in 84 cases,with a detection rate of 87.50%.The SCSA detection compliance rate was96.42%,which was higher than 85.71%of conventional ultrasound,with a statistically significant difference(χ^(2)=5.929,P<0.05).The sensitivity of SCSA in the diagnosis of severe fetal limb malformations in early pregnancy was 95.24%,the accuracy was 94.79%,and the negative predictive value was 73.33%,higher than 80.95%,79.17%,33.33%of conventional ultrasonography,with statistically significant differences(χ^(2)=8.173,10.347,5.912,P<0.05).However,the difference in specificity and positive predictive value between the two methods was not statistically significant when compared(χ^(2)=1.011,1.092,P>0.05).The Kappa test showed that ultrasound examination of lymph node metastases in patients with DTC was in good agreement with the“gold standard”findings(Kappa value=0.785,P<0.001).Conclusion:SCSA has high sensitivity and accuracy,and its can be used as an effective measure for early pregnancy screening to diagnose severe fetal limb anomalies.

关 键 词：早孕期胎儿严重肢体畸形 连续顺序追踪超声法 诊断效能 灵敏度 特异度 准确度 

分 类 号：R730.41[医药卫生—肿瘤]