NT超声联合孕中期四维彩超检查在产前胎儿畸形筛查中的应用价值

The application value of NT ultrasound combined with four-dimensional ultrasound in prenatal fetal malformation screening

目的探讨孕早期胎儿颈项透明层厚度(NT)超声检查联合孕中期四维彩超检查在产前胎儿畸形筛查中的应用价值。方法选取2018年1月至2019年12月我院定期产检孕妇1205例,均给予产前二维彩超、NT超声及孕中期四维彩超检查。随访至产后,分析检查结果。结果1205例孕妇孕早期(孕11~14w)产检中,确诊异常胎儿46例,NT超声检出异常胎儿44例,诊断符合率为95.7%。继续妊娠的1186例孕妇孕中期(孕22~28w)产检中,确诊异常胎儿29例,四维彩超检出异常胎儿29例,诊断符合率为100.0%。NT异常胎儿染色体异常率高于NT正常胎儿,差异有统计学意义(P<0.05)。NT超声联合孕中期四维彩超检查诊断胎儿畸形的灵敏度、特异度、准确度分别为96.8%、100.0%、99.9%,均高于二维彩超的71.1%、82.2%、81.9%,差异均有统计学意义(P<0.05)。结论NT超声检查有助于评估胎儿唐氏综合征风险,孕中期四维超声检查有助于诊断胎儿结构异常,二者联合有助于提高产前胎儿畸形筛查效率。

Objective:To investigate the application value of nuchal translucency thickness(NT)ultrasound combined with four-dimensional ultrasound in prenatal fetal malformation screening.Methods:1205 pregnant women were selected from January 2018 to December 2019.All pregnant women were given prenatal two-dimensional ultrasound,NT ultrasound and four-dimensional ultrasound examination.Follow up to postpartum,analysis of the results.Results:1205 cases in early trimester(11~14 weeks)of pregnancy,46 cases were diagnosed as abnormal fetuses,44 cases were detected as abnormal fetuses by NT ultrasound,the diagnostic coincidence rate was 95.7%.Among the 1186 cases in mid trimester(22~28 weeks)of pregnancy,29 cases were diagnosed as abnormal fetuses,29 cases were detected as abnormal fetuses by four-dimensional ultrasound,and the diagnostic accuracy rate was 100.0%.The abnormal rate of chromosome abnormality in NT was higher than that in NT normal fetus(P<0.05).The sensitivity,specificity and accuracy of NT ultrasound combined with four-dimensional ultrasound in the diagnosis of fetal malformation were 96.8%,100.0%and 99.9%,which were higher than those of two-dimensional ultrasound(71.1%,82.2%and 81.9%)(P<0.05).Conclusion:NT ultrasound is helpful to assess the risk of fetal Down′s syndrome,four-dimensional ultrasound is helpful to diagnosis the fetal structural abnormalities.The combination can improve the efficiency of prenatal fetal malformation screening.