四维超声在产前胎儿肢体畸形筛查中的应用研究  

Application of Four-Dimensional Ultrasound in Prenatal Screening of Fetal Limb Deformities

作　　者：谭梦伟 周文柏 孙宁 TAN Mengwei;ZHOU Wenbo;SUN Ning(Department of Ultrasound,Changzhou Maternal and Child Health Hospital,Changzhou,Jiangsu 213000,China)

机构地区：[1]常州市妇幼保健院超声科,江苏常州213000

出　　处：《转化医学杂志》2024年第11期1871-1874,共4页Translational Medicine Journal

基　　金：江苏省卫生健康委科研项目(M2021079)。

摘　　要：目的探讨四维超声在产前胎儿肢体畸形筛查中的应用价值。方法回顾性收集2022年1月至2023年12月常州市妇幼保健院接受产前胎儿畸形筛查的1865例孕妇的临床和影像学资料,所有孕妇均接受常规二维超声、四维超声检查,以引产后新生儿畸形或实际分娩为金标准,比较常规二维超声、四维超声检查结果对于胎儿肢体畸形诊断的价值。结果1865例孕妇共检出16例(0.86%)胎儿肢体畸形,6例经引产证实,10例经分娩后证实。产前常规二维超声检查共诊断出9例肢体畸形,与尸检或分娩后检查结果的一致性中等(Kappa值=0.433)。产前四维超声检查共诊断出14例肢体畸形,与尸检或分娩后检查结果的一致性较好(Kappa值=0.715)。常规二维超声产前筛查胎儿肢体畸形的灵敏度、特异度和准确率分别为56.25%、99.14%、98.77%,四维超声产前筛查胎儿肢体畸形的灵敏度、特异度和准确率分别为87.50%,99.51%、99.41%,四维超声产前筛查胎儿肢体畸形的曲线下面积高于常规二维超声(0.777 vs 0.935,Z=3.862,P<0.05)。结论四维超声在产前胎儿肢体畸形筛查中较常规二维超声价值更高,可降低漏误诊风险。Objective To explore the application value of four-dimensional ultrasound in prenatal screening of fetal limb malformations.Methods Clinical and imaging data of 1,865 pregnant women who received prenatal screening for fetal malformations at Changzhou Maternal and Child Health Hospital from January 2022 to December 2023 were retrospectively collected.All pregnant women underwent routine two-dimensional ultrasound and four-dimensional ultrasound,with neonatal malformations or actual delivery after labor induction as the gold standard.The value of routine two-dimensional ultrasound and four-dimensional ultrasound in diagnosing fetal limb malformations was compared.Results In 1,865 pregnant women,16 cases(0.86%)of fetal limb malformations were detected,6 cases were confirmed by labor induction and 10 cases were confirmed after delivery.A total of 9 cases of limb deformities were diagnosed by prenatal routine two-dimensional ultrasound,and the agreement with autopsy or postnatal examination results was moderate(Kappa value=0.433).A total of 14 cases of limb deformities were diagnosed by prenatal four-dimensional ultrasound,which showed good agreement with the results of autopsy or post-delivery examination(Kappa value=0.715).The sensitivity,specificity,and accuracy of prenatal screening for fetal limb malformations by routine two-dimensional ultrasound were 56.25%,99.14%,and 98.77%,respectively.The sensitivity,specificity,and accuracy of prenatal screening for fetal limb malformations by four-dimensional ultrasound were 87.50%,99.51%,and 99.41%,respectively.The area under the curve(AUC)of four-dimensional ultrasound for prenatal screening of fetal limb malformations was higher than that of routine two-dimensional ultrasound(0.777 vs 0.935,Z=3.862,P<0.05).Conclusion Four-dimensional ultrasound has higher value than routine two-dimensional ultrasound in prenatal screening for fetal limb malformations and can reduce the risk of misdiagnosis.

关 键 词：胎儿肢体畸形 产前筛查 常规二维超声 四维超声 

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]