产前彩色多普勒超声检查在胎儿泌尿系统畸形诊断中的效能

Efficacy of prenatal color Doppler ultrasonography in diagnosis of fetal urinary system malformations

目的:观察产前彩色多普勒超声检查在胎儿泌尿系统畸形诊断中的效能。方法:选取2017年7月至2020年7月该院收治的7331例孕妇进行前瞻性研究,所有孕妇均行产前彩色多普勒超声检查,将随访结果作为诊断泌尿系统畸形的“金标准”,采用Kappa检验分析产前彩色多普勒超声检查诊断结果与“金标准”的一致性,并分析产前彩色多普勒超声检查在胎儿泌尿系统畸形诊断中的效能。结果:金标准结果显示,通过对7331例孕妇的后期随访,包括产后超声随访、引产病理随访和手术病理的检查结果显示共有117例胎儿发生泌尿系统畸形,占1.59%;产前彩色多普勒超声检查结果显示,113例胎儿发生泌尿系统畸形,产前彩色多普勒超声检查诊断胎儿泌尿系统畸形的灵敏度为96.58%,特异度为99.94%,准确度为99.95%,阳性预测值和阴性预测值分别为96.58%和99.96%。Kappa检验结果显示,产前彩色多普勒检查诊断泌尿系统畸形与“金标准”的一致性良好(Kappa=0.949,P=0.000)。结论:产前彩色多普勒超声检查在泌尿系统畸形诊断中具有较高的效能。

Objective: To observe efficacy of prenatal color Doppler ultrasonography in diagnosis of fetal urinary system malformations.Methods: A prospective study was conducted on 7331 pregnant women admitted to the hospital from July 2017 to July 2020. All pregnant women underwent prenatal color Doppler ultrasonography. Using the follow-up results as the “gold standard” for the diagnosis of urinary system malformations, Kappa test was used to calculate the consistency between the prenatal color Doppler ultrasonography and the “gold standard”. Then,the efficacy of prenatal color Doppler ultrasonography in the diagnosis of fetal urinary system malformations was analyzed. Results: The results of the gold standard showed that among the 7331 pregnant women, 117 fetuses had urinary system malformations, accounting for 1.59%, based on the follow-up of these pregnant women, including postpartum ultrasound follow-up, induced labor pathological follow-up and surgical pathology. The results of prenatal color Doppler ultrasonography showed that 113 fetuses had urinary system malformations. The sensitivity, specificity, accuracy,positive predictive value and negative predictive value of prenatal color Doppler ultrasonography in the diagnosis of fetal urinary system malformation were 96.58%, 99.94%, 99.95%, 96.58% and 99.96%, separately. Kappa test results showed that the consistency between prenatal color Doppler examination and the “gold standard” in the diagnosis of urinary system malformations was good(Kappa0.949, P=0.000). Conclusions: Prenatal color Doppler ultrasonography has high efficiency in the diagnosis of urinary system malformations.