产前三维超声与四维超声诊断胎儿畸形的效果观察

Effect of prenatal three-dimensional ultrasound and four-dimensional ultrasound in diagnosis of fetal malformations

目的研究产前三维超声和四维超声诊断胎儿畸形的临床效果。方法以2018年1月至2020年1月于南阳市豫西协和医院接受产前检查的230例孕妇临床资料为本次研究对象进行回顾性分析,以出生或引产后胎儿情况为金标准,比较三维超声和四维超声诊断胎儿畸形的效能。结果四维超声检查诊断胎儿骨骼畸形准确度96.96%(223/230),三维超声检查准确度92.61%(213/230),四维超声准确度高于三维超声(P<0.05);四维超声检查胎儿神经系统畸形准确度96.09%(221/230),三维超声检查敏感度55.56%(20/36),特异度97.42%(189/194),准确度90.87%(209/230),四维超声准确度高于三维超声(P<0.05);四维超声检查胎儿心脏畸形准确度96.96%(223/230),三维超声检查准确度92.61%(213/230),四维超声准确度高于三维超声(P<0.05)。结论四维超声对胎儿畸形检出率和诊断价值高于三维超声检查,适宜于在产前检查中推广应用。

【Objective】To study the clinical effect of prenatal three-dimensional ultrasound and four-dimensional ultrasound in the diagnosis of fetal malformations.【Methods】The clinical data of 230 cases of pregnant women who received prenatal examination in our hospital from January 2018 to January 2020 were retrospectively analyzed,and the effectiveness of three dimensional ultrasound and four-dimensional ultrasound in the diagnosis of fetal malformation was compared with the gold standard of the fetal situation after birth or induced labor.【Results】The accuracy of four-dimensional ultrasound in the diagnosis of fetal skeletal malformation was 96.96%(223/230),the accuracy of three-dimensional ultrasound was 92.61%(213/230),the accuracy of four-dimensional ultrasound was significantly higher than that of three-dimensional ultrasound(P<0.05);the accuracy of four dimensional ultrasound in the diagnosis of fetal nervous system malformation was 96.09%(221/230),the sensitivity of three dimensional ultrasound was 55.56%(20/36),the specificity was 97.42%(189/194),and the accuracy was 90.87%(209/230),the accuracy of four-dimensional ultrasound was significantly higher than that of three-dimensional ultrasound(P<0.05);the accuracy of four-dimensional ultrasound in the diagnosis of fetal cardiac malformation was 96.96%(223/230),the accuracy of three-dimensional ultrasound was 92.61%(213/230),the accuracy of four-dimensional ultrasound was significantly higher than that of three dimensional ultrasound(P<0.05).【Conclusion】Four-dimensional ultrasound has higher detection rate and diagnostic value than three-dimensional ultrasound in the diagnosis of metal malformation,which is suitable for prenatal examination.