MRI联合超声对胎儿中枢神经系统先天畸形的临床诊断价值

Clinical Diagnostic Value of MRI Combined with Ultrasound in Fetal Congenital Malformations of Central Nervous System

目的探讨MRI联合超声对胎儿中枢神经系统先天畸形的诊断价值。方法63例疑似胎儿中枢神经系统先天畸形的孕妇均行MRI和超声检查。以最终诊断为标准,分析MRI、超声单独及联合检查诊断胎儿中枢神经系统先天畸形的效能以及与最终诊断的一致性。结果联合检查和MRI检查诊断胎儿中枢神经系统先天畸形的敏感度、准确度均高于超声检查(P<0.05),但联合检查与MRI检查的诊断敏感度、特异度、准确度比较,差异无统计学意义(P>0.05)。Kappa检验显示,MRI检查与金标准的一致性中等(Kappa=0.598,P<0.001),超声检查与金标准的一致性较差(Kappa=0.267,P<0.05),二者联合检查与金标准的一致性较高(Kappa=0.764,P<0.001)。结论MRI联合超声对胎儿中枢神经系统先天畸形具有较高的诊断价值。

Objective To explore the diagnostic value of MRI combined with ultrasound in fetal congenital malformations of central nervous system.Methods 63 pregnant women with suspected fetal congenital malformations of central nervous system were examined by MRI and ultrasound.With the final diagnosis as the standard,the efficacy and consistency with the final diagnosis of single examination and combined examination of MRI and ultrasound in the diagnosis of fetal congenital malformations of central nervous system were analyzed.Results The sensitivity and accuracy of combined examination and MRI examination in the diagnosis of fetal congenital malformations of central nervous system were higher than those of ultrasound examination(P<0.05);No significant difference was found in diagnostic sensitivity,specificity and accuracy between combined examination and MRI examination(P>0.05).Kappa test showed that the consistency between MRI and the gold standard was moderate(Kappa=0.598,P<0.001),the consistency between ultrasound and the gold standard was poor(Kappa=0.267,P<0.05),and the consistency between the combined examination and the gold standard was high(Kappa=0.764,P<0.001).Conclusions MRI combined with ultrasound has high diagnostic value in fetal congenital malformations of central nervous system.