三维超声断层显像技术对胎儿泌尿系统畸形的诊断价值

Three- dimensional ultrasound tomography imaging systems for the diagnostic value of fetal malformation of the urinary system

目的探讨三维超声断层显像技术对产前胎儿泌尿系统畸形的诊断价值。方法回顾性分析2011~2014年门诊产前检查经三维超声断层显像、二维超声检查拟诊断为泌尿系统畸形的42例胎儿的临床资料,以产后超声、MRI、手术或尸检结果作为金标准,对两种产前检查方法进行诊断学效能评价。结果经产后超声、MRI、手术或尸检结果最终诊断的泌尿系统畸形有41例,二维超声诊断重复肾输尿管末端闭锁或异位、双肾发育不全、一侧肾缺如、多囊肾的结果与最终诊断的符合率均为100%,总体对泌尿系统畸形的诊断符合率达到80.49%;三维超声断层显像诊断一侧肾发育不全或不良、肾积水、重复肾输尿管末端闭锁或异位、一侧肾缺如、单发肾囊肿、多囊肾、马蹄肾的结果与最终诊断结果符合率达到100%,整体诊断符合率达到95.12%。三维超声断层显像技术诊断的符合率显著的高于二维超声（χ2=4.100,P〈0.05）。二维超声诊断的灵敏度为80.49%,特异度为100%,漏诊率为19.51%,误诊率为0。三维超声断层显像诊断的灵敏度为95.12%,特异度为100%,漏诊率为4.88%,误诊率为0。结论三维超声断层显像技术对产前胎儿泌尿系统畸形具有较高的诊断价值。

Objective To discuss on three dimensional tomographie ultrasound imaging technology on the value of prenatal diagnosis of fe- tal malformation of the urinary system. Methods A retrospective analysis was performed from 2011 to 2014 outpatient antenatal examination by 3D ultrasound tomography. A two - dimensional ultrasound examination diagnosed as fetal malformation in urinary system in 42 cases. Ultrasound and MRI in postpartum, surgery or autopsy results were regarded as the gold standard for diagnosis. The efficacy evaluation of two kinds of prenatal examination method was performed. Results Multiparous ultrasound or MRI after surgery or autopsy results, final diagnosis was established in 41 cases. The two - dimensional ultrasound made the diagnosis of duplication of kidney and ureter end locking or ectopic, double renal hypoplasia, a- genesis of kidney, polycystic kidney on one side of the results and the final diagnosis coincidence rate was 100%. The rate was 80.49% with the overall diagnosis of the urinary system malformation three dimensional tomographic ultrasound imaging diagnosis. In the diagnosis of one side renal hypoplasia or bad, hydronephrosis, renal duplication end locking or ectopic, one side renal agenesis, solitary renal cyst and polycystic kidney, horseshoe kidney results, the final diagnosis coincidence rate reached 100%. The rate was 95.12% in line with the overall diagnosis. Three di- mensional tomographic ultrasound diagnostic imaging technology conformity rate was significantly higher than the two - dimensional ultrasound （X2 = 4. 100, P 〈 0.05）. Two dimensional ultrasound diagnostic sensitivity and specificity was 80.49%, 100%. The rate of missed diagnosis and misdiagnosis rate was 0, 19.51%. Tomographic imaging of three - dimensional ultrasound in diagnosis of sensitivity, specificity was 95. 12%, 100%, the rate of missed diagnosis and misdiagnosis rate was 0, 4.88%. Conclusion Diagnostic value of three - dimensional ultrasound tomo-graphy technique has higher prenatal fetal malformation of the urinary system.