胎儿MRI图像质量因素的回归分析及其在胎儿脑室扩张诊断中的价值研究

发布时间：2018-05-01 13:23

本文选题：磁共振 + 超声　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:在我国,每年大约有100万先天缺陷或畸形的婴儿出生,其中中枢系统类发育不全的婴儿仍为首位,为家庭和社会带来了沉重的负担。因此,及早准确诊断胎儿的中枢神经系统疾病,有助于提高优生优育,对家庭和社会稳定具有重要作用。产前超声(ultrasound,US)检查一直是胎儿产前首选的影像学检查方法,但是超声检查在一定程度上也存在不足,需要其他检查方法加以完善。MRI有着无射线损伤、良好的软组织对比及空间分辨率、广阔的视野等优势,完全具备成为超声检查之外的另一种重要的胎儿产前影像学检查方法的条件。本研究拟通过分析比较MRI技术和超声技术在检测胎儿脑室扩张方面的诊断一致性,探讨MRI应用于胎儿检查的价值;同时,对影响胎儿磁共振图像质量因素作回归分析,在实际操作中,避免可控的影响因素,提高胎儿磁共振图像质量,为准确诊断胎儿中枢神经系统疾病奠定基础。方法:选取2014年3月至2015年11月在我院行胎儿超声检查并提示胎儿脑室扩张并随后进行MRI检查的120例孕妇作为研究对象,分析其超声及磁共振技术检测结果,实验室染色体分析、孕妇血清学TORCH检测、以及随访结果。探讨影响胎儿磁共振图像质量因素作回归分析研究以及比较超声技术和MRI技术在检测胎儿脑室扩张方面的诊断价值。结果:第一部分经过Logistic多因素回归分析,我们统计得到心率(P0.001,Exp(B)=1.054)、胎动情况(P0.001,Exp(B)=20.04)、呼吸情况(P0.001,Exp(B)=4.07)、羊水量(P0.001,Exp(B)=1.05)对胎儿磁共振图像质量的影响有显著意义,而孕周(P=0.54)对于磁共振图像质量无明显统计学差异。因此,影响胎儿磁共振图像质量的因素包括:孕妇呼吸、心率、胎动、羊水量。在第二部分研究中,超声诊断胎儿脑室扩张的120例中,有92例胎儿超声和MRI结果纳入本研究中。磁共振符合超声确诊率为73.9%、MRI补充诊断率为26.1%。结论:本研究第一部分研究认为在胎儿MRI检查中,孕妇平稳呼吸、心率正常、胎动不明显等是保证图像质量的重要因素;第二部分表明MRI检查可以作为超声检查胎儿脑室扩张的重要补充手段,其在检查诊断胎儿脑室扩张合并其它中枢神经系统疾病中的诊断价值明显优于超声检查。
[Abstract]:Objective: about 1 million babies with congenital defects or deformities are born every year in China. Therefore, early and accurate diagnosis of fetal central nervous system diseases is helpful to improve eugenics, and play an important role in family and social stability. Prenatal ultrasound ultrasound (USS) is always the first choice for prenatal imaging of fetus, but there are some deficiencies in ultrasound examination to a certain extent, and other examination methods need to be improved. MRI has no X-ray injury. The advantages of good soft tissue contrast, spatial resolution, wide field of vision and so on, fully possess the condition of becoming another important prenatal imaging method besides ultrasound examination. The purpose of this study was to analyze and compare the diagnostic consistency of MRI and ultrasound in the detection of fetal ventricular dilatation, to explore the value of MRI in fetal examination, and to make regression analysis on the factors affecting the quality of fetal magnetic resonance imaging. In practice, we can avoid controllable influencing factors, improve the quality of fetal magnetic resonance imaging, and lay a foundation for the accurate diagnosis of fetal central nervous system diseases. Methods: from March 2014 to November 2015, 120 pregnant women with fetal ventricular dilation and subsequent MRI examination were selected to analyze the results of ultrasound and magnetic resonance imaging (MRI), which were performed in our hospital from March 2014 to November 2015. Laboratory chromosome analysis, maternal serological TORCH test, and follow-up results. To study the factors influencing the quality of fetal magnetic resonance image and compare the diagnostic value of ultrasound and MRI in detecting fetal ventricular dilatation. Results: in the first part, by Logistic multivariate regression analysis, we found that the effects of heart rate, fetal movement, respiration, amniotic fluid volume and amniotic fluid volume on the quality of fetal magnetic resonance imaging were significant. However, there was no significant difference in the quality of magnetic resonance imaging (P < 0. 54). Therefore, factors affecting the quality of fetal magnetic resonance imaging include: maternal respiration, heart rate, fetal movement, amniotic fluid. In the second part of the study, 92 cases of fetal ventricular dilatation were diagnosed by ultrasound, 92 cases of fetal ultrasound and MRI results were included in this study. The diagnostic rate of MRI in accordance with ultrasonography was 73.9% and the rate of MRI supplementary diagnosis was 26.1%. Conclusion: in the first part of this study, it is considered that the smooth breathing, normal heart rate and unobvious fetal movement are the important factors to ensure the image quality in fetal MRI examination. The second part shows that MRI can be used as an important supplementary method for fetal ventricular dilatation, and its diagnostic value in diagnosing fetal ventricular dilatation with other central nervous system diseases is obviously superior to that of ultrasound.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R714.5

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