4DUS联合TUI技术对产前筛查胎儿面部畸形诊断价值

Application value of 4DUS combined with TUI technology in the diagnosis of fetal facial malformations

目的我国为出生缺陷、残疾率高发国家,早期确诊并干预畸形对提高新生儿出生质量具有重要意义,本研究旨在探讨四维超声成像(four-dimensional ultrasound imaging,4DUS)联合断层超声成像(tomography ultrasound imaging,TUI)技术在接受产前筛查孕妇胎儿面部畸形诊断中的应用价值。方法选取2017-08-01—2018-12-31新乡市中心医院产前胎儿面部畸形筛查孕妇546例作为研究对象,均予以4DUS、TUI检查,以分娩或引产为"金标准",分析4DUS、TUI单独与联合检查结果,对比4DUS、TUI单独与联合检查诊断效能。结果546例产前胎儿面部畸形筛查孕妇经分娩或引产证实胎儿面部畸形20例,其中唇裂4例,唇腭裂8例,面部皮肤增厚2例,面横裂3例,其他3例;4DUS检出20例,TUI技术检出19例,联合检出26例;联合4DUS、TUI技术诊断敏感性为100.00%(20/20),较单独诊断高,χ~2=7.500,P=0.024;4DUS、TUI技术联合诊断特异性为98.86%(520/526),与单独诊断对比,差异无统计学意义,χ~2=1.317,P=0.518。结论联合4DUS、TUI技术可提高产前胎儿面部畸形筛查的灵敏度,降低漏诊事件发生。

OBJECTIVE China is a country with a high incidence of birth defects and disability.Early diagnosis and intervention of deformities are of great significance to improve the quality of newborn births,the purpose of this study was to explore the value of four-dimensional ultrasound imaging(4 DUS)combined tomographic ultrasound(TUI)technology in the diagnosis of fetal facial deformities in pregnant women undergoing prenatal screening.METHODS From Augest 01,2017 to December 31,2018,546 pregnant women with prenatal fetal facial deformity screening in Xinxiang Central Hospital were selected as the research subjects.4 DUS and TUI examinations were performed,and the labor and induction of labor were used as the"gold standard".The results of 4 DUS and TUI separate and combined examinations were analyzed.The diagnostic efficacy of 4 DUS and TUI alone and combined examination was compared.RESULTS Totally 546 prenatal fetal facial malformations were screened in 20 pregnant women who had confirmed fetal facial deformities through childbirth or induction.There were 4 cases of cleft lip,8 cases of cleft lip and palate,2 cases of facial skin thickening,3 cases of lateral fissure,and 3 cases of other types.Twenty cases were detected by 4 DUS,19 cases were detected by TUI technology,and 26 cases were detected jointly.The diagnostic sensitivity of the combined 4 DUS and TUI technology was 100.00%(20/20),which is higher than the diagnosis alone,χ~2=7.500,P=0.024.The specificity of the combined diagnosis of 4 DUS and TUI technology was 98.86%(520/526).Compared with the individual diagnosis,the difference was not statistically significant,χ~2=1.317,P=0.518.CONCLUSION Combining 4 DUS and TUI technology can improve the sensitivity of prenatal fetal facial deformity screening and reduce the incidence of missed diagnosis.