颈项透明层厚度检测联合孕中期的四维彩超检测在胎儿畸形诊断中的参考价值分析

The reference value analysis of cervical transparent layer thickness detection combined with four-dimensional color Doppler ultrasound detection in the diagnosis of fetal malformation

目的分析颈项透明层厚度检测联合孕中期的四维彩超检测在胎儿畸形诊断中的参考价值。方法选取2016年6月至2018年8月于我院行胎儿畸形筛查的1952位孕妇为研究对象,所有研究对象均接受了胎儿的颈项透明层的厚度的超声检测和孕中期四维彩超的检测,分析各检测方法的筛查结果,并对产后结果进行随访追踪。结果胎儿颈项透明层厚度的超声检测出27例畸形胎儿,后随访确诊30例,漏诊率为10%;孕中期四维彩超胎儿畸形检测提示29例胎儿,后随访确诊31例,漏诊率为6.4%;颈项透明层厚度超声检测、四维超声以及联合检测的AOC曲线下面积分别为0.68、0.71、0.83,联合检测的诊断敏感性显著高于单独的颈项透明层厚度超声检测和四维超声检测(P均>0.05)。结论颈项透明层厚度检测联合孕中期的四维彩超检测在胎儿畸形诊断中具有较好的参考价值,临床上应结合实际情况使用。

Objective:To analyze the reference value of four-dimensional color Doppler ultrasound detection in the diagnosis of fetal malformation with detection of cervical transparent layer thickness. Methods:A total of 1952 pregnant women who underwent fetal malformation screening from August 2016 to August 2018 were enrolled. All subjects underwent ultrasound examination of the thickness of the cervical transparent layer of the fetus and the fourth trimester of the second trimester. The screening results of each test method were analyzed,and the postpartum results were followed up. Results:Twenty-seven cases of malformed fetuses were detected by ultrasonography,and 30 cases were diagnosed by follow-up. The missed diagnosis rate was 10%. In the second trimester,the four-dimensional color Doppler fetal malformation test showed 29 cases of fetuses,and 31 cases were confirmed by follow-up. The rate of missed diagnosis was 6.4%. The area under the AOC curve of the transparent layer thickness of the cervical transparent layer,the four-dimensional ultrasound and the combined detection were 0.68,0.71,and0.83,respectively. The diagnostic sensitivity of the combined detection was significantly higher than that of the separate cervical transparent layer thickness ultrasonic testing and four-dimensional ultrasonic testing(P>0.05). Conclusion:The detection of neck transparent layer thickness combined with the four-dimensional color Doppler ultrasound detection in the second trimester has a good reference value in the diagnosis of fetal malformation. It should be used clinically in combination with the actual situation.