胎儿颈项透明层检测质量控制及其在染色体异常检出中的意义

Quality Control of Nuchal Translucency Test for Screening Chromosomal Abnormalities

目的:评价胎儿颈项透明层(NT)的质量控制方法及其在染色体异常胎儿检出中的意义。方法:抽取我院2008年10月至2013年10月间NT检查胎儿共2306例,应用Herman评分方法对其NT图像质量进行分析。胎儿分为A组(n=1408)和B组(n=898),A组胎儿图像评分大于或等于7分,B组小于7分,比较两组胎儿染色体检查结果。结果:A组中,NT厚度≥2.5mm者78例,78例胎儿中染色体异常8例,另有1例21-三体综合征胎儿NT厚度<2.5mm,于中孕期检出。B组中,NT厚度≥2.5mm者22例,22例胎儿中染色体异常1例,另有4例21-三体综合征胎儿NT厚度<2.5mm,其中3例于中孕期检出,1例出生。A组筛查的敏感性(89%)较B组(20%)增高(P﹤0.05)。结论:利用Herman评分对胎儿NT测量的质量控制是可行的、必要的。

Purpose：To assess the quality control of Nuchal Translucency （NT） test for screening chromosomal abnormalities.Methods：From October 2008 to October 2013,2306 cases who were referred to our fetal medicine department for first trimester ultrasound screening were collected,the stored digital NT images were reviewed for each case and the image of NT measurement was scored.The fetus were divided into two groups according to the score,which in group A（n=1408） was 7-9 points,in group B（n=898） was less than 7 points.The chromosomal abnormalities were recorded.The sensitivity of the test was compared between group A and group B.Results：In group A,78 fetuses were with a nuchal translucency of greater than or equal to 2.5 mm,8 of 9 fetuses with chromosomal abnormalities were found in the 78 fetuses.In group B,22 fetuses were with a nuchal translucency of greater than or equal to 2.5 mm,1 of 5 fetuses with chromosomal abnormalities were found in the 22 fetuses.The value of sensitivity in group A （8/9,89％） was significantly higher than that in group B （1/5,20％） （P＜0.05）.Conclusion：It is feasible and necessary to assess the quality of NT images for screening chromosomal abnormalities.