二维超声与四维超声联合应用对胎儿隐性脊柱裂的研究

发布时间：2018-09-11 20:44

【摘要】：目的探讨二维超声与四维超声联合应用对胎儿隐性脊柱裂的诊断价值。方法选择2013年1月至2015年12月到本院进行产前筛查,经普通超声检查怀疑脊柱发育异常且不能明确诊断的胎儿的孕妇80例,根据诊断方法不同将孕妇分为两组,比较两组超声诊断胎儿隐性脊柱裂的效果、超声影像质量、漏诊和误诊率等指标,以评价四维超声的准确性、安全性和临床应用价值。结果二维超声检查确诊隐性脊柱裂2例,四维超声检查确诊7例,新生儿出生后随访结果隐性脊柱裂为8例。二维超声检查与随访结果一致性比较,Kappa=0.184,两者诊断一致性较低;四维超声检查与随访结果一致性比较,Kappa=0.769,两者诊断一致性较好。二维超声诊断胎儿隐性脊柱裂的准确率为25%,四维超声诊断胎儿隐性脊柱裂的准确率为100%,χ2=4.001,P0.05,差异具有统计学意义。二维超声检出的2例隐性脊柱裂均为孕晚期孕妇,占二维超声检出率的100%。四维超声检出的3例隐性脊柱裂均为孕中期孕妇,占四维超声检出率的37.50%;5例为孕晚期,占四维超声检出率的62.50%。结论超声检查是产前筛查胎儿隐性脊柱裂的简单有效的首选方法,四维超声动态检查可弥补二维超声检查的不足而提供清晰、直观,连续的动态的声像图而提高诊断的准确性。
[Abstract]:Objective to evaluate the diagnostic value of two-dimensional ultrasound and four-dimensional ultrasound in the diagnosis of fetal recessive spina bifida. Methods from January 2013 to December 2015, 80 pregnant women with suspected spinal dysplasia and undiagnosed fetuses were selected and divided into two groups according to different diagnostic methods. In order to evaluate the accuracy, safety and clinical value of four-dimensional ultrasound, we compared the effect, quality, missed diagnosis and misdiagnosis rate of fetal recessive spina bifida between the two groups. Results 2 cases of occult spina bifida were diagnosed by two dimensional ultrasonography, 7 cases were confirmed by four dimensional ultrasonography, 8 cases were diagnosed as occult spina bifida after birth. The consistency of two dimensional ultrasound examination with follow-up results was 0.184, the diagnostic consistency between them was low, and that between four dimensional ultrasound examination and follow up results was 0.769. the diagnostic consistency between the two methods was good. The accuracy of 2-D ultrasound in diagnosis of fetal recessive spina bifida was 25%, and that of four-dimensional ultrasound was 100% (蠂 ~ 2 + 4.001) (P 0.05), the difference was statistically significant. Two cases of recessive spina bifida detected by two dimensional ultrasound were all pregnant women in late pregnancy, accounting for 100% of the detection rate of 2 D ultrasound. The 3 cases of recessive spina bifida detected by four dimensional ultrasound were all pregnant women in the second trimester, and the detection rate of four dimensional ultrasound was 37.50% in 5 cases of late pregnancy and 62.50% of the detection rate of four dimensional ultrasound. Conclusion Ultrasonography is a simple and effective method for prenatal screening of fetal recessive spina bifida. Four-dimensional dynamic ultrasonography can make up for the deficiency of two-dimensional ultrasonography and provide clear, intuitive and continuous dynamic sonography to improve the accuracy of diagnosis.
【作者单位】：柳州市工人医院;
【基金】：广西卫生厅课题(Z2013629)
【分类号】：R445.1;R714.5

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