彩色多普勒超声产前诊断脐带入口异常的临床研究

Clinical Study on the Color Doppler Ultrasound in Prenatal Diagnosis of Umbilical Entrance Abnormality

目的探讨彩色多普勒超声产前诊断脐带入口异常的应用价值。方法回顾性分析180例脐带入口异常孕妇的临床资料,比较不同孕期彩超对边缘性脐带入口与帆状脐带入口的检出率,观察边缘性脐带入口和帆状脐带入口的彩超图像表现。结果边缘性脐带入口异常及帆状脐带入口异常的患者在孕中期的彩色多普勒超声诊断检出率分别为95.6%、93.3%,均显著高于孕晚期检出率80.0%、73.3%,差异具有统计学意义(P<0.05)。彩色多普勒超声产前诊断脐带入口异常的真阳性率为85.6%(154/180),假阴性率为14.4%(26/180)。结论无论是边缘性脐带入口异常或是帆状脐带入口异常的孕妇,在孕中期的彩色多普勒超声检查的正确率均显著高于孕晚期,这为产前诊断胎儿脐带入口异常最佳时期的选择提供了依据,有助于提高彩超的诊断真阳性率,为早期确诊胎儿脐带入口异常提供了较高的应用价值。

Objective To investigate the application value of color Doppler ultrasound in prenatal diagnosis of umbilical entrance abnormality. Methods The clinical data of 180 pregnant women with umbilical entrance abnormality were retrospectively analyzed. The detection rates of color Doppler ultrasound in diagnosis of marginal umbilical entrance and velamentous umbilical entrance during different gestation period were compared, and the ultrasound findings of the two types of umbilical entrance were observed. Results The detection rates of color Doppler ultrasound in diagnosis of marginal umbilical entrance and velamentous umbilical entrance during second trimester were 95.6% and 93.3% respectively, significantly higher than 80.0% and 73.3% during third trimester, with statistical difference （P 〈0.05）. The true positive rate of color Doppler ultrasound in prenatal diagnosis of umbilical entrance abnormality was 85.6% （154/180）, and the false negative rate was 14.4% （26/180）. Conclusions The detection rates of color Doppler ultrasound in diagnosis of pregnant women with marginal umbilical entrance abnormality and velamentous umbilical entrance abnormality during second trimester are higher than those during third trimester. The result provides basis for the optimum period selection of prenatal diagnosis of umbilical entrance abnormality, provides high application value for early definite diagnosis of umbilical entrance abnormality, and contributes to improving the true positive rate of color Doppler ultrasound.