二维超声和三维超声对胎儿颜面部畸形的诊断价值比较

Comparison of diagnostic value of two-dimensional ultrasound and three-dimensional ultrasound in fetal facial deformity

目的比较二维超声和三维超声对胎儿颜面部畸形的诊断价值。方法选取2016年1月至2020年12月于我院进行产前检查的85例疑似胎儿颜面部畸形的高危孕中期孕妇作为研究对象,分别给予二维超声及三维超声检查。以分娩或引产后的结果作为诊断金标准,比较二维超声及三维超声诊断胎儿颜面部畸形的符合率;比较二维超声及三维超声对胎儿颜面部畸形的诊断价值及两种方法与金标准检出情况的一致性。结果85例疑似胎儿颜面部畸形的孕妇中,24例在本院完成引产或分娩后证实为颜面部畸形;三维超声诊断胎儿颜面部畸形的符合率为83.33%(20/24),高于二维超声的45.83%(11/24)(P<0.05)。三维超声对胎儿颜面部畸形的诊断灵敏度、准确度、漏诊率、阴性预测值均显著优于二维超声(P<0.05);三维超声对胎儿颜面部畸形的诊断结果与金标准检出情况的一致性极高(Kappa=0.849,P<0.01)。结论相较于常规的二维超声,三维超声对胎儿颜面部畸形的诊断价值较高,值得在高危孕妇产前检查中推广应用。

Objective To compare the diagnostic value of two-dimensional ultrasound and three-dimensional ultrasound in fetal facial deformity.Methods A total of 85 high-risk pregnant women in the second trimester of pregnancy with suspected fetal facial deformity who received prenatal examination in our hospital from January 2016 to December 2020were selected as the research objects,and two-dimensional ultrasound and three-dimensional ultrasound were respectively given.The results after delivery or induction of labor were used as the diagnostic gold standard,and the coincidence rate of two-dimensional ultrasound and three-dimensional ultrasound in the diagnosis of fetal facial deformity was compared;the diagnostic value of two-dimensional ultrasound and three-dimensional ultrasound in fetal facial deformity,and the consistency between the two methods and the gold standard were compared.Results Among the 85 pregnant women with suspected fetal facial deformity,24 cases of facial deformity were confirmed after labor induction or delivery in our hospital;the coincidence rate of three-dimensional ultrasound in the diagnosis of fetal facial deformity was 83.33%(20/24),which was higher than 45.83%(11/24)of two-dimensional ultrasound(P<0.05).The diagnostic sensitivity,accuracy,missed diagnosis rate and negative predictive value of three-dimensional ultrasound for fetal facial deformity were significantly better than those of two-dimensional ultrasound(P<0.05);the diagnostic results of three-dimensional ultrasound for fetal facial deformity were very consistent with the gold standard(Kappa=0.849,P<0.01).Conclusion Compared with conventional two-dimensional ultrasound,three-dimensional ultrasound has higher diagnostic value for fetal facial deformity,which is worthy of promotion and application in prenatal examination of high-risk pregnant women.