MRI结合超声诊断胎儿CNS畸形的价值观察

Value of MRI Combined with Ultrasound in Diagnosis of Fetal CNS Malformation

目的观察MRI结合超声诊断胎儿中枢神经系统(CNS)畸形的价值。方法回顾性分析2016年6月至2019年2月十堰市妇幼保健院怀疑胎儿CNS畸形的80例孕妇临床资料,均行超声、MRI检查,比较其图像质量,并以胎儿出生后结果或胎儿尸检结果为金标准,分析MRI、超声、MRI与超声联合诊断价值。结果超声的血流及脉络丛室管膜显示图像质量评分较MRI高,超声的视野、分辨率、对组织特异性及脑沟、裂、回显示图像质量评分较MRI低,差异有显著性(P<0.05);超声联合MRI检查诊断胎儿CNS畸形的灵敏度、准确度高于单纯超声检查,联合检查准确度也高于单纯MRI检查(P<0.05)。结论MRI结合超声检查诊断胎儿CNS畸形的价值较单纯超声或MRI检查更高,MRI可作为补充手段、弥补单纯超声检查的不足,提高诊断灵敏度、准确度,值得在临床推广。

Objective To observe the value of MRI combined with ultrasound in diagnosis of fetal central nervous system(CNS)malformation.Methods Clinical data of 80 pregnant women who were suspected with fetal CNS malformation and admitted to Shiyan Maternal and Child Health Hospital between July 2016 and February 2019 were analyzed retrospectively.All subjects completed ultrasound and MRI examination,and image quality was compared.With birth outcome or fetal autopsy results asthe golden standard,the diagnostic value of MRI,ultrasound and combination of the twowas analyzed.Results The image quality scores of ultrasound in terms of blood flow and choroid plexus ependyma display were higher than those of MRI,while image quality scores in terms ofvisual field,resolution,display of tissue specificity,sulcus,fissure and gyrus were lower than those of MRI(P<0.05).The sensitivity and accuracy of ultrasound combined with MRI in the diagnosis of fetal CNS malformation were higher than those of simple ultrasound examination.The accuracy of combination examination was also higher than that of MRI alone(P<0.05).Conclusion The value of MRI combined with ultrasound in the diagnosis of fetal CNS malformation is higher than that of ultrasound or MRI alone.MRI can be used as a supplementary means to make up for the deficiency of ultrasound alone and improve the sensitivity and accuracy of diagnosis,which is worthy of clinical promotion.