彩超联合磁共振对胎儿胆囊异常的诊断效能及参数变化

Diagnostic efficacy of color Doppler ultrasound combined with magnetic resonance imaging for fetal gallbladder abnormalities and its parametric variation

目的:彩超及联合磁共振在胎儿胆囊异常产前诊断中的应用效果。方法:回顾性收集2018年1月-2020年1月本院产前检查孕妇5289例临床资料,对5342个胎儿进行多普勒超声和磁共振检查,比较单用彩超与彩超联合磁共振对胎儿胆囊异常的诊断效能。结果:产前超声胆囊显示率为99.9%(5334/5342例),胆囊异常检出率为0.7%(38/5342例),包括胆囊增大22例、小胆囊4例、回声异常3例、双胆囊1例。磁共振检查胆囊显示率为100.0%,胆囊异常检出率0.6%(33/5342例),包括双胆囊3例、胆囊增大24例、小胆囊6例。随着孕周增大,磁共振测得胎儿胆囊长度、宽度和体积增加(P<0.05)。孕3235周胎儿胆囊长度、宽度、横径及体积均大于孕2831周胎儿(P<0.05)。产前超声联合磁共振诊断胎儿胆囊异常的假阳性率(0.02%)、假阴性率(8.57%)低于超声检查(0.35%、14.29%),阳性预测值(96.97%)高于超声检查(78.95%)(P<0.05)。结论:磁共振和彩超在胎儿胆囊异常诊断中各有优缺点,二者联用可有效减少胎儿胆囊异常的漏误诊风险。

Objective: To study the application effect of color Doppler ultrasound combined with magnetic resonance imaging(MRI) for diagnosing fetal gallbladder abnormalities. Methods: The clinical data of 5289 pregnant women were collected retrospectively. 5342 fetus of these women were given examined by color Doppler ultrasound and MRI. The efficacy of ultrasonography alone for diagnosing fetal gallbladder abnormalities compared with that of ultrasonography combined with MRI. Results: The display rate of fetal gallbladder and the detection rate of gallbladder abnormalities by prenatal ultrasound were 99.9%(5334/5342) and 0.7%(38/5342), which included 22 fetuses with gallbladder enlargement, 4 fetuses with small gallbladder, 3 fetuses with abnormal echo, and 1 fetus with double gallbladder. The display rate of fetal gallbladder and the abnormal gallbladder detection rate by MRI were 100.0% and 0.6%(33/5342), which included 3 fetuses with double gallbladder, 24 fetuses with gallbladder enlargement, and 6 fetuses with small gallbladder. With gestational weeks increasing, the length, the width, and the volume of the fetal gallbladder had increased by MRI(P<0.05). The length, the width, the transverse diameter, and the volume of the fetal gallbladder during 32-35 gestational weeks were significant higher than those of the fetal gallbladder during 28-1 gestational weeks(P<0.05). The false positive rate(0.02%) and false negative rate(8.57%) of prenatal ultrasound combined with MRI for diagnosing fetal gallbladder abnormalities were significant lower than those(0.35% and 14.29%) of ultrasound, and the positive predictive value(96.97%) of prenatal ultrasound combined with MRI for diagnosing fetal gallbladder abnormalities was significant higher than that(78.95%) of ultrasound(P<0.05). Conclusion: the color ultrasound combined with MRI for diagnosing fetal gallbladder abnormalities have their own advantages and disadvantages. The combination of the color ultrasound and MRI can effectively reduce the risk of misdiagnosis of fetal gallbladder abnormalities.