彩色多普勒超声检查诊断胎儿胆囊异常的准确率临床评价

Cliniceal evaluation of the ahe diagnosis of fetal gallbladler abnormalities

目的:探讨在针对胎儿胆囊异常所开展的诊断工作中,应用彩色多普勒超声技术实施检查的准确率情况。方法:对来本院开展产前检查的5500例孕妇资料予以收集,时间为2019年6月至2021年6月,均采用彩色多普勒超声技术实施检查,并以引产或产后诊断结果作为金标准,就彩色多普勒超声技术诊断效能进行评估,同时,分析影像学特征。结果:本次所抽取的5500例产前检查的孕妇中,依据引产和产后获取的信息,提示胎儿胆囊异常16例,其中,胆囊异常增大11例,占比为0.19%;胆囊腔内强回声5例,占比为0.09%。采用彩色多普勒超声技术实施检查,显示胎儿胆囊异常14例,其中,胆囊异常增大10例,占比为0.18%;胆囊腔内强回声4例,占比为0.07%,检出率比较差异无统计学意义(P>0.05)。以引产和产后结果做金标准,对彩色多普勒超声诊断效能进行评估,其中在对胆囊异常增大实施诊断时,灵敏度为90.91%,特异度为100.00%,准确度为99.98%。在对胆囊腔内强回声实施诊断时,灵敏度为80.00%,特异度为100.00%,准确度为99.98%。针对采用彩色多普勒超声实施检查,检出的10例胆囊异常增大的胎儿开展规范的染色体检查操作,结果显示,18-三体胎儿2例,整倍体胎儿1例,其余未见明显异常,染色体异常率为30.00%,对于异常的胎儿,产妇均在知情同意的前提下接受引产术,对妊娠予以终止。对4例采用彩色多普勒超声进行检查,检出的胎儿胆囊腔内强回声的孕妇,经复诊,回声呈消失显示3例,仍有强回声检出1例,未采取特殊措施处理,待出生后对其进行随访,无黄疸等问题。对于10例胆囊呈异常增大显示的胎儿,经对其染色体进行检查,存在异常3例,均经引产的方式将妊娠终止。其余为微小畸形和孤立性胆囊增大,胎儿均表现为活产的情况。对于4例胎儿胆囊存在异常回声的胎儿,经随访,均为活产。结论:针对胎儿胆囊异常疾病,在进行诊断过程中,运用多普勒超声技术加以监测,可将胆囊异常增大的问题,胆囊腔内强回声问题胎儿及时检出,针对染色体存在异常者,需采取引产的方式及时对妊娠终止,进而为提升分娩质量提供强有力的保障。

Objective:To investigate the accuracy of the application of color Doppler ultrasonography in the diagnosis of fetal gallbladder abnormalities.Methods:The data of 5500 pregnant women who came to our hospital for prenatal examination were collected from June 2019 to June 2021.Color Doppler ultrasonography was used for examination,and the results of labor in-duction or postpartum diagnosis were used.As the gold standard,the diagnostic performance of color Doppler ultrasonography was evaluated,and imaging features were analyzed.Results:Among the 5500 pregnant women who underwent prenatal exami-nation,16 cases were suggested to have abnormal fetal gallbladder according to the information obtained from induction of labor and postpartum.Among them,1l cases were abnormally enlarged gallbladder,accounting for 0.19%.There were 5 cases of echo,accounting for 0.09%.Color Doppler ultrasonography was used for examination,and 14 cases of fetal gallbladder abnor-malities were found,among which,10 cases of abnormal gallbladder enlargement,accounting for 0.18%.4 cases of strong echo in the gallbladder cavity,accounting for O.07%,the detection rate was compared.The difference was not statistically sig-nificant(P>0.05).Taking labor induction and postpartum results as the gold standard,the diagnostic performance of color Doppler ultrasound was evaluated.When diagnosing abnormal gallbladder enlargement,the sensitivity was 90.91%,the speci-ficity was 100.00%,and the accuracy was 99.98%.In the diagnosis of strong echo in the gallbladder cavity,the sensitivity was 80.00%,the specificity was 100.00%,and the accuracy was 99.98%.Standard chromosomal examination was carried out for 1o fetuses with abnormally enlarged gallbladder detected by color Doppler ultrasonography.The results showed that there were 2 fetuses with trisomy 18,1 fetus with euploidy,and the rest were not obvious.Abnormal,the chromosomal abnormality rate was 30.00%.For abnormal fetuses,all mothers accepted labor induction under the premise of informed consent,and the pregnancy was terminated.4 cases of pregnant women with strong echo in the fetal gallbladder were detected by color Doppler ultrasound.After follow-up,3 cases showed that the echo disappeared,and 1 case was still detected with strong echo,and no special measures were taken to deal with it.To be followed up after birth,no jaundice and other problems.For 1o fetuses with abnormally enlarged gallbladder,the chromosomes were checked and there were 3 cases of abnormality,all of which were terminated by induction of labor.The rest were micromalformations and isolated gallbladder enlargement,and the fetuses were all live births.For 4 fetuses with abnormal echo in the fetal gallbladder,all were live births during follow-up.Conclusion:For abnormal fetal gallbladder disease,in the process of diagnosis,using Doppler ultrasound technology to monitor,can detect the problem of abnormal gallbladder enlargement and strong echo in the gallbladder cavity of the fetus in time.Induction of labor is adopted to terminate pregnancy in a timely manner,thereby providing a strong guarantee for improving the quality of delivery.