胎儿颈后透明层厚度超声检查联合孕中期四维超声系统检查对胎儿结构畸形的诊断价值分析

Analysis of the Diagnostic Value of Nuchal Translucency Ultrasonography Combined with Mid-Pregnancy Four-Dimensional Ultrasound System Examination in the Diagnosis of Fetal Structural Malformations

目的:探讨胎儿颈后透明层厚度(NT)超声检查联合孕中期四维超声系统检查在胎儿结构畸形诊断中的应用价值。方法:选取2021年6月~2023年6月于本院行常规超声检查疑似胎儿结构畸形的225例孕妇作为研究对象,均行NT超声检查、四维超声检查,并以引产或分娩结果为金标准,统计胎儿结构畸形检出情况及诊断价值;以Kappa检验验证不同方法诊断与金标准的一致性。结果:225例疑似孕妇金标准确诊胎儿畸形52例,其中NT超声检查检出45例,阳性率为86.54%(45/52);四维超声检出47例,阳性率为90.38%(47/52);联合检查检出51例,阳性率为98.08%(51/52);联合检查诊断的灵敏度、准确度高于任意单一检查,阴性预测值高于NT超声检查(P<0.05);采用Kappa检验显示,NT超声检查、四维超声、联合检查诊断胎儿畸形与金标准的Kappa值分别为0.829、0.858、0.962,一致性极好。结论:NT超声检查联合孕中期四维超声检查可提高胎儿结构畸形诊断效能,便于早期发现畸形胎儿进行针对性处理,确保优生优育。

Objective:To explore the application value of nuchal translucency thickness(NT)ultrasonography combined with mid-pregnancy four-dimensional ultrasonography in the diagnosis of fetal structural malformations.Methods:225 pregnant women with suspected fetal structural malformations who underwent routine ultrasonography in our hospital from June 2021 to June 2023 were selected as the study subjects,and all of them underwent NT ultrasonography and four-dimensional ultrasonography,and the results of induced labor or delivery were used as the gold standard to statistically detect fetal structural malformations and their diagnostic value;The consistency of the diagnosis of the different methods with the gold standard was verified by the Kappa test.Results:52 cases of fetal malformations were diagnosed by the gold standard in 225 suspected pregnant women,of which 45 cases were detected by NT ultrasonography,with a positive rate of 86.54%(45/52);47 cases were detected by four-dimensional ultrasonography,with a positive rate of 90.38%(47/52);51 cases were detected by the combined examination,with a positive rate of 98.08%(51/52);The sensitivity and accuracy of diagnosis of the combined examination were higher than that of any single examination,and the negative predictive value was higher than that of NT ultrasonography,(P<0.05);The Kappa test was used to show that the Kappa values of NT ultrasonography,four-dimensional ultrasonography,and combined examination for diagnosis of fetal anomalies and the gold standard were 0.829,0.858,and 0.962,respectively,which were in excellent agreement.Conclusion:NT ultrasonography combined with four-dimensional ultrasonography in mid-pregnancy can improve the diagnostic efficacy of fetal structural malformations,facilitate the early detection of malformed fetuses for targeted treatment,and ensure eugenics.