彩色多普勒超声在胎儿神经管畸形筛查中的应用效果分析  

Application Effect Analysis of Color Doppler Ultrasound in Screening of Fetal Neural Tube Defects

作　　者：李晓 LI Xiao(Daye People's Hospital,Daye 435100,China)

机构地区：[1]大冶市人民医院,湖北大冶435100

出　　处：《中外医学研究》2023年第23期82-85,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析彩色多普勒超声(CDU)在胎儿神经管畸形(NTDs)筛查中的应用价值。方法:回顾性分析2021年1月-2022年1月于大冶市人民医院行产前超声检查的108例产检孕妇的超声检查结果,记录NTDs检出情况,并对孕妇引产或产后结局、胎儿健康进行随访跟踪,分析产前CDU在NTDs筛查中的应用价值。结果:(1)108例产检孕妇中病理确诊NTDs 5例,包括无脑儿1例,脑膨出1例,开放性脊柱裂2例,隐形脊柱裂1例,畸形检出率为4.63%;CDU检查结果筛查出NTDs 4例,漏诊隐形脊柱裂1例,检出率为3.70%,符合率为80%(4/5),漏诊率为20%(1/5)。(2)CDU在无脑儿、脑膨出、脊柱裂方面有明显的胎头呈蛙头状、胎头光环不全、椎管后壁部分不完整等影像学特征。(3)4例NTDs胎儿CDU检出时间分别为16周、17周、24周、26周。(4)NTDs胎儿11~13周透明层厚度(NT)值大于正常发育胎儿,差异有统计学意义(P<0.05)。NT值预测胎儿发生NTDs曲线下面积(AUC)为0.876,敏感度为80.00%,特异度为84.47%。结论:CDU在NTDs筛查中符合率相对较高,具有一定的应用价值,但需把握产检时间,以降低漏诊率。Objective:To analyze the application value of color Doppler ultrasound(CDU)in the screening of fetal neural tube defects(NTDs).Method:Retrospective analysis was made on the ultrasound examination results of 108 pregnant women who underwent prenatal ultrasound examination in Daye People's Hospital from January 2021 to January 2022.The detection of NTDs was recorded,and follow-up was made on the induced labor or postpartum outcome of pregnant women,and fetal health.The application value of prenatal CDU in screening of NTDs was analyzed.Result:(1)Among 108 pregnant women,5 cases were pathologically diagnosed as NTDs,including 1 anencephaly,1 encephalocele,2 open spina bifida,and 1 spina bifida occulta,the detection rate of malformations was 4.63%;4 cases of NTDs were screened by CDU examination results,and 1 case of spina bifida occulta was missed,the detection rate was 3.70%,the coincidence rate was 80%(4/5),and the missed diagnosis rate was 20%(1/5).(2)In terms of anencephaly,encephalocele and spina bifida,CDU has obvious imaging characteristics such as frog head,incomplete halo of fetal head,and incomplete posterior wall of vertebral canal.(3)The detection time of CDU in four NTDs fetuses was 16 weeks,17 weeks,24 weeks,and 26 weeks,respectively.(4)The thickness of the transparent layer(NT)of NTDs fetuses at 11-13 weeks was greater than that of normal developing fetuses,and the difference was statistically significant(P<0.05).The area under the NTDs curve(AUC)predicted by the NT value for fetal development is 0.876,with a sensitivity of 80.00%and a specificity of 84.47%.Conclusion:The accuracy of CDU is relatively high in NTDs screening,and CDU has certain application value.However,it is necessary to control the time of prenatal examination to reduce the rate of missed diagnosis.

关 键 词：彩色多普勒超声 产前 胎儿神经管畸形 筛查 

分 类 号：R714.5[医药卫生—妇产科学]