四维彩色多普勒超声与二维超声对胎儿畸形诊断效能的比较分析

The comparative analysis of diagnostic performance between four-dimensional ultrasound and two-dimensional ultrasound in fetal malformation

目的比较四维彩超与二维超声在诊断胎儿先天性畸形的诊断效能。方法选择2015年2月至2017年6月在我院进行产前检查的产妇3 759名为研究对象,分别对其进行四维彩色多普勒超声与二维超声检查,以病理检查和随访结果为金标准,以符合率、灵敏度、特异度、漏诊率和误诊率评价两种检查方法的诊断效能。结果 3 759名产妇中,病理结果显示先天性畸形胎儿333例,四维超声检出阳性322例,漏诊11例,误诊15例。二维超声检出阳性273例,漏诊60例,误诊31例。两组之间比较,除特异度两组之间无差异外,四维超声的诊断灵敏度和对多种畸形类型的诊断符合率高于二维超声(P<0.05或P<0.01),而漏诊率、误诊率低于二维超声(P<0.05或P<0.01)。结论四维彩色多普勒超声对胎儿先天性畸形的诊断效能显著优于二维超声,具备临床推广价值。

Objective To compare the diagnostic performance between four-dimensional ultrasound and twodimensional ultrasound in fetal malformation. Methods Clinical data of 3 759 cases pregnant women in our hospital from February 2013 to June 2017 were retrospectively analyzed, they all underwent the four-dimensional ultrasound and two-dimensional ultrasound, based on pathologic examination and the follow-up results as the gold standard, coincidence rate, sensitivity, specific degrees, the missed diagnosis and misdiagnosis rate diagnostic performance evalua-tion of the two kinds of inspection methods were compared. Results The pathological results showed 333 cases with congenital malformation fetus, while four dimensional ultrasound detected 322 cases, with missed diagnosis in 11 cas-es, and 15 cases were misdiagnosed; two-dimensional ultrasonography detected 273 cases, 60 cases were missed diagnosis, misdiagnosis in 31 cases. By comparison between the of two groups, in addition to specific degrees with no significant difference 4 d ultrasound diagnostic sensitivity and malformation type to the variety of the diagnostic coin-cidence rate was significantly higher than that of the two-dimensional ultrasound（P〈0.05 or P〈0.01）, and significantly lower than the missed diagnosis and misdiagnosis rate was significantly lower than the two-dimensional ultrasound（P〈0.05 or P〈0.01）. Conclusion The diagnostic performance of four-dimensional color ultrasound is significantly better than two-dimensional ultrasound and has clinical value.