应用足底平面第一与第五跖骨夹角评价胎儿先天性足内翻

发布时间：2018-03-31 16:54

本文选题：畸形足　切入点：胎儿疾病　出处：《中国临床医学影像杂志》2015年11期

【摘要】：目的:探讨测量足底平面第一与第五跖骨夹角在诊断先天性足内翻中的价值。方法:对照组选择孕周为19~37周的117例胎儿共186只胎足,病例组选择先天性足内翻的24例胎儿37只胎足,应用TUI模式显示足底平面并测量第一与第五跖骨夹角,分析正常胎儿该角度与其孕周的相关性,并比较两组之间该角度的差异;同时利用ROC曲线判断其诊断价值。对病例组胎儿于其出生或引产后进行随访并进行DR检查,于正位片上测量第一与第五跖骨夹角,并将超声测量结果与DR测量结果进行对比分析及一致性检验。结果:对照组第一与第五跖骨夹角为(22.83±2.07)°,与孕周无明显相关性(r=0.104,P=0.1580.05)。病例组第一与第五跖骨夹角的测量结果为(32.91±3.30)°,与对照组相比差异有统计学意义(P=0.0000.05)。ROC曲线下面积为0.978,曲线上的最佳临界点为27.47°,对应的敏感度为94.6%,特异度为97.8%。正常足与内翻足的DR正位片测量结果分别为(23.28±1.16)°、(33.59±3.02)°,超声测量结果与之相比差异均无统计学意义(P=0.4710.05,P=0.2810.05)。一致性检验所得Kappa值分别为0.811和0.894(P=0.0000.05),说明二者诊断的一致性较好。结论:正常胎儿足底平面第一与第五跖骨夹角与孕周无明显相关性。先天性足内翻胎儿第一与第五跖骨夹角与正常胎儿相比角度明显增大。
[Abstract]:Objective : To investigate the value of the included angle between the first and fifth metatarsal bones in the diagnosis of congenital clubfoot by measuring the angle between the first and the fifth metatarsal bones in the control group . The angle between the first and fifth metatarsal bones was measured by using the TUI model . The results showed that the included angle between the first and fifth metatarsal bones was ( 22.83 卤 2.07 ) 掳 , and the correlation between the first and fifth metatarsal bones was not significantly correlated with the pregnancy week ( r = 0.104 , P = 0 . 150.05 ) . The results were ( 32.91 卤 3.30 ) 掳 and ( 32.91 卤 3.30 ) 掳 respectively . The area under ROC curve was 0.978 , the best critical point on the curve was 27.47 掳 , the corresponding sensitivity was 94.6 % , and the specificity was 97.8 % . The results of the measurement of DR positive position were ( 23.28 卤 1.16 ) 掳 and ( 33.59 卤 3.02 ) 掳 , respectively , and the difference was not statistically significant ( P = 0.471 . 05 , P = 0.2810.05 ) . The results showed that the included angle between the first and fifth metatarsal bones in the first and fifth metatarsal bones of the normal fetus increased significantly compared with the normal fetus .

【作者单位】：中国医科大学附属盛京医院超声科;
【基金】：盛京自由研究者计划(201209) “十一五”国家科技支撑计划项目(2006BAI05A04)
【分类号】：R714.5;R445.1

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