实时三维超声彩色多普勒检查在孕中期胎儿畸形中的诊断价值

The Diagnostic Value of Real-time Three-dimensional Color Doppler Ultrasound in Mid-term Fetal Malformations

目的分析实时三维超声彩色多普勒检查在孕中期胎儿畸形中的诊断价值。方法选取安阳市第六人民医院2021年7月至2023年7月收治的250例有胎儿畸形高危因素的孕中期孕妇,利用实时二维超声检查、三维超声彩色多普勒检查胎儿发育情况;所有受试者均接受跟踪随访,将引产或死产后尸检结果、活产后新生儿检查结果记为“金标准”,分析实时三维超声彩色多普勒检查、二维超声检查对孕中期胎儿畸形诊断的价值。结果金标准诊断结果显示,250例受试者中有3例失访、20例转院,均剔除,余227例受试者中有80例孕中期胎儿畸形,其中鼻骨发育不良9例、无脑儿3例、脑积水5例、脊柱畸形3例、唇腭裂7例、心脏畸形26例、前腹壁畸形者3例、肢体畸形6例、肾脏疾病4例、胸腔疾病4例、单脐动脉10例。实时三维超声彩色多普勒检查畸形胎儿的检出率(93.67%)高于二维超声检查(80.32%),差异有统计学意义(P<0.05),实时三维超声彩色多普勒检查预测孕中期胎儿畸形的灵敏度为85.21%、特异度为93.75%、准确度为89.62%。结论实时三维超声彩色多普勒检查在孕中期胎儿畸形中的诊断价值较高。

Objective To analyze the diagnostic value of real-time three-dimensional color Doppler ultrasound in mid-term fetal malformations.Methods 250 mid-term pregnant women with high-risk factors for fetal malformations were selected from July 2021 to July 2023 in the Sixth People’s Hospital of Anyang.The fetal development was examined using real-time two-dimensional ultrasound and three-dimensional color Doppler ultrasound.All subjects were followed up,and the results of post-abortion or stillbirth autopsy,and postpartum neonatal examination were recorded as the“gold standard”.The value of real-time three-dimensional color Doppler ultrasound and two-dimensional ultrasound in the diagnosis of mid-term fetal malformations was analyzed.Results The gold standard diagnostic results showed that among the 250 subjects,3 were lost to follow-up and 20 were transferred to other hospitals,all of which were excluded.Among the remaining 227 subjects,there were 80 cases of mid-term fetal malformations,including 9 cases of poor nasal bone development,3 cases of anencephaly,5 cases of hydrocephalus,3 cases of spinal deformities,7 cases of cleft lip and palate,26 cases of heart malformations,3 cases of anterior abdominal wall deformities,6 cases of limb deformities,4 cases of kidney diseases,4 cases of thoracic diseases,and 10 cases of single umbilical artery.The detection rate of malformed fetuses by real-time three-dimensional color Doppler ultrasound(93.67%)was higher than that of two-dimensional ultrasound(80.32%),and the difference was statistically significant(P<0.05).The sensitivity,specificity,and accuracy of real-time three-dimensional color Doppler ultrasound in predicting mid-term fetal malformations were 85.21%,93.75%,and 89.62%,respectively.Conclusion The diagnostic value of real-time three-dimensional color Doppler ultrasound in mid-term fetal malformations is high.