四维彩色多普勒超声用于孕中期胎儿唇腭裂筛查中的临床价值分析

Clinical Value Analysis of Four-dimensional Color Doppler Ultrasonography in the Screening of Fetal Cleft Lip and Palate in the Second Trimester

目的:分析四维彩色多普勒超声用于孕中期胎儿唇腭裂筛查中的临床价值。方法:选择2016年5月—2020年5月景德镇市妇幼保健院进行产前二维超声检查疑为唇腭裂畸形的85例胎儿。入选者均采用二维及四维超声检查。以引产及自然分娩结果作为诊断唇腭裂畸形的“金标准”,比较二维、四维超声诊断唇腭裂畸形准确率,比较二维、四维超声在唇腭裂畸形严重程度中的诊断准确率。结果:85例疑似为唇腭裂畸形的胎儿经引产或自然分娩均确诊为唇腭裂畸形,其中唇裂、腭裂、唇腭裂各有24例、21例、40例。四维超声诊断唇裂(100.00%)、腭裂(95.24%)、唇腭裂准确率(100.00%)高于二维超声(58.33%、28.57%、70.00%),差异有统计学意义(χ^(2)=12.632、19.789、14.118、43.923,P<0.05)。四维超声在Ⅱ度唇裂(100.00%)、Ⅰ度及Ⅱ度腭裂(90.00%、100.00%)、Ⅰ度唇腭裂畸形诊断中准确率(100.00%)高于二维超声(37.50%、0、37.50%、20.00%),差异有统计学意义(χ^(2)=4.655、12.929、4.655、10.208,P<0.05)。结论:四维彩色多普勒超声用于孕中期胎儿唇腭裂筛查中,能够提高更为准确、全面的影像学信息,提高唇腭裂诊断准确率,并准确判断唇腭裂畸形严重程度,对实现优生优育具有重要影响。

Objective:To analyze the clinical value of four-dimensional color Doppler ultrasound in the screening of fetal cleft lip and palate in the second trimester.Methods:A total of 85 fetuses suspected of cleft lip and palate were selected for prenatal two-dimensional ultrasonography in the hospital from May 2016 to May 2020.All participants were examined by two-dimensional and four-dimensional ultrasonography.The results of induced labor and natural childbirth were regarded as the“gold standard”for the diagnosis of cleft lip and palate.The accuracy of 2D and 4D ultrasound in the diagnosis of cleft lip and palate was com⁃pared,and the diagnostic accuracy of 2D and 4D ultrasound in the severity of cleft lip and palate was compared.Results:Eighty-five fetuses suspected of having cleft lip and palate were diagnosed with cleft lip and palate deformity through induction or natural delivery,including 24,21,and 40 cases of cleft lip,cleft palate,and cleft lip and palate.The accuracy rate of four-dimen⁃sional ultrasound in the diagnosis of cleft lip(100.00%),cleft palate(95.24%),and cleft lip and palate(100.00%)was higher than those of two-dimensional ultrasound(58.33%,28.57%,70.00%),and the difference was statistically significant(χ^(2)=12.632,19.789,14.118,43.923,P<0.05).The accuracy rate(100.00%)of four-dimensional ultrasound in the diagnosis of second-degree cleft lip(100.00%),first-and second-degree cleft palate(90.00%,100.00%),and first-degree cleft lip and palate deformity(100.00%)was higher than those of two-dimensional ultrasonography(37.50%,0,37.50%,20.00%),the difference was statistically significant(χ^(2)=4.655,12.929,4.655,10.208,P<0.05).Conclusion:The use of four-dimensional color Doppler ultrasound in the screening of fetal cleft lip and palate in the second trimester can improve more accurate and comprehensive imaging information,improve the diagnostic accuracy of cleft lip and palate,and accurately determine the severity of cleft lip and palate deformity.It has an important impact on the realization of prenatal and postnatal care.