四维彩超在胎儿下腔静脉走行变异中的诊断价值

Diagnostic value of four-dimensional color Doppler ultrasound for inferior vena cava variation in fetus

目的探讨四维彩超在胎儿下腔静脉走行变异中的应用。方法选取2019年5月至2021年6月陕西省核工业二一五医院收治的疑似下腔静脉走行变异的胎儿共63例,所有胎儿均行二维彩超、四维彩超检查,以出生后超声或引产后尸体解剖结果为金标准,比较二维彩超、四维彩超对胎儿下腔静脉走行变异的诊断效能。结果63例胎儿59例确诊为下腔静脉走行变异,经产后新生儿超声证实有49例,经引产后胎儿尸体解剖证实有10例,其中左位下腔静脉走行变异31例,双下腔静脉走行变异28例。二维超声诊断结果显示55例为下腔静脉走行变异,四维超声诊断结果显示61例为下腔静脉走行变异。四维超声诊断准确率为96.83%,明显高于二维超声的88.89%,差异有统计学意义(P<0.05);两种检查方法诊断胎儿下腔静脉走行变异的灵敏度、特异度、阳性预测值、阴性预测值比较差异均无统计学意义(P>0.05)。结论四维彩超在诊断胎儿下腔静脉走行变异中价值较高,有利于产前筛查胎儿下腔静脉畸形而尽早干预,提高优质生育率。

Objective To investigate the application of four-dimensional color Doppler ultrasound in diagnosing inferior vena cava variation in fetus.Methods A total of 63 pregnant women who were suspected of inferior vena cava variation in fetus,and admitted to Shaanxi Nuclear Industry 215 Hospital from May 2019 to June 2021 were selected.All the patients were examined with two-dimensional and four-dimensional color Doppler ultrasound.Postnatal ultrasonography results or post-induction autopsy results were taken as the golden standard to compare the diagnostic performance of two-dimensional and four-dimensional color Doppler ultrasound for inferior vena cava variation in fetus.Results Among the 63 fetuses,59 were diagnosed with inferior vena cava variation,of which 49 were confirmed by postnatal ultrasound and 10 by autopsy after labor induction,respectively.Among them,there were 31 fetuses with left inferior vena cava variation and 28 fetuses with double inferior vena cavavariation.The examination results of two-dimensional ultrasound and four-dimensional ultrasound showed 55 fetuses and 61 fetuses with inferior vena cava variation,respectively.The diagnostic accuracy of four-dimensional ultrasound was significantly higher than that of two-dimensional ultrasound(96.83%vs 88.89%,P<0.05),but there was no statistically significant difference in sensitivity,specificity,positive predictive value or negative predictive value between the two examination methods in the diagnosis of inferior vena cava variation in fetus(P>0.05).Conclusion Four-dimensional color Doppler ultrasound is helpful for prenatal screening of fetal inferior vena cava variation,and can thereby improve the high-quality fertility rate.