产前超声评估胎儿侧脑室扩张的临床价值  

Clinical value of prenatal ultrasound in evaluating fetal lateral ventricular dilatation

作　　者：陈莘妍 何静 宋伯慧 CHEN Shenyan;HE Jing;SONG Bohui(Department of Ultrasound,Leshan Maternal and Child Health Hospital,Sichuan 614000,China)

机构地区：[1]四川省乐山市妇幼保健院超声科,614000 [2]广元市中医院超声科

出　　处：《临床超声医学杂志》2024年第9期778-782,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨产前超声评估胎儿侧脑室扩张及其严重程度的临床应用价值。方法选取我院产前检查发现胎儿侧脑室扩张的孕妇98例(扩张组)和同期胎儿侧脑室正常的孕妇98例(正常组),应用超声获取两组胎儿侧脑室宽度、第三脑室纵径(CD)、丘脑间粘合最大径(ITAD);于出生1周内采用新生儿神经行为(NBNA)评分和Gesell发育量表评估新生儿神经脑发育情况,比较两组超声指标、NBNA评分及Gesell评分的差异。采用Pearson相关分析法分析扩张组胎儿侧脑室宽度、CD、ITAD与NBNA评分、Gesell评分的相关性。绘制受试者工作特征(ROC)曲线分析侧脑室宽度、CD、ITAD对胎儿侧脑室扩张的诊断效能。根据侧脑室扩张严重程度将扩张组进一步分为轻度组24例、中度组45例和重度组29例,比较各组超声指标、NBNA评分及Gesell评分的差异。结果扩张组侧脑室宽度、CD均高于正常组,ITAD、NBNA评分、Gesell评分均低于正常组,差异均有统计学意义(均P<0.001)。扩张组侧脑室宽度、CD分别与NBNA评分、Gesell评分呈负相关(均P<0.001),ITAD与NBNA评分、Gesell评分均呈正相关(均P<0.001)。ROC曲线分析显示,侧脑室宽度诊断胎儿侧脑室扩张的曲线下面积为0.907,灵敏度为92.86%,特异度为76.53%,曲线下面积高于CD和ITAD(0.815、0.856),差异均有统计学意义(均P<0.05)。重度组侧脑室宽度、CD均高于轻、中度组,ITAD、NBNA评分、Gesell评分均低于轻、中度组,差异均有统计学意义(均P<0.05)。结论产前超声可有效评估胎儿侧脑室扩张及其严重程度,具有较好的临床应用价值。Objective To explore the clinical application value of prenatal ultrasound in the evaluation of fetal lateral ventricular dilation and its degree.Methods A total of 98 pregnant women with fetal lateral ventricular dilatation(dilatation group)detected by prenatal examination and 98 pregnant women with normal fetal lateral ventricle(control group)were selected from our hospital.Fetal lateral ventricle width,longitudinal diameter of third ventricle(CD),maximum interthalamic adhesive diameter(ITAD)were obtained by ultrasonography.And neonatal neurodevelopment status was assessed by neonatal neurobehavioral assessment(NBNA)score and Gesell developmental scale.The differences in ultrasound indicators,NBNA score and Gesell score were compared between the two groups.The correlation between prenatal lateral ventricle width,CD,ITAD and NBNA score and Gesell score of fetuses in dilatation group were analyzed by Pearson correlation analysis.The diagnostic efficiency of fetal lateral ventricle width,CD and ITAD for fetal lateral ventricular dilatation was analyzed by receiver operating characteristic(ROC)curve.According to the severity of lateral ventricular dilatation,the dilatation group were divided into mild group(n=24),moderate group(n=45)and severe group(n=29),and the differences in ultrasound indicators,NBNA score and Gesell score were compared.Results The lateral ventricle width and CD in dilatation group were higher than those in control group,while the ITAD,NBNA score and Gesell score were lower than those in control group(all P<0.001).The fetal lateral ventricle width and CD were negatively correlated with NBNA score and Gesell score(all P<0.001),while ITAD was positively correlated with NBNA score and Gesell score(both P<0.001).ROC curve analysis showed that the area under the curve(AUC),sensitivity and specificity of lateral ventricle width in the diagnosis of fetal lateral ventricular dilatation were 0.907,92.86%and 76.53%,respectively.And the AUC of lateral ventricle width was higher than that of CD and ITAD(bo

关 键 词：超声检查 产前 侧脑室扩张 胎儿 预后 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]