二维三平面超声联合三维超声对胎儿唇腭裂的诊断价值

The Diagnostic Value of Two-Dimensional Three Plane Ultrasound Combined with Three-Dimensional Ultrasound for Fetal Cleft Lip and Palate

目的探究二维三平面超声联合三维超声(3DUS)对胎儿唇腭裂的诊断价值。方法选取2020年2月至2023年8月于医院进行系统排畸彩色超声检查的8079名早中期孕产妇(胎儿8135例),均接受二维三平面超声、3DUS检查初步筛查唇腭裂状况,并以引产、产后颜面部结果为金标准,分析二维三平面超声、3DUS及联合检查对胎儿唇腭裂的诊断价值。结果8079名早中期孕产妇(8135例胎儿)经引产、产后颜面部检查,检出唇腭裂129例(1.59%),其中单纯腭裂20例、唇裂40例、唇腭裂69例。以引产、产后颜面部检查结果为金标准,二维三平面超声联合3DUS检查唇腭裂总符合率高于单独检查,差异有统计学意义(P<0.05);二维三平面超声联合3DUS检查唇腭裂与金标准一致性极好(Kappa=0.826)。二维三平面超声联合3DUS检查唇腭裂的特异度、准确度、阳性预测值均高于单独检查,差异有统计学意义(P<0.05);单独及联合检查的灵敏度、阴性预测值比较,差异无统计学意义(P>0.05)。结论二维三平面超声联合3DUS对胎儿唇腭裂的诊断价值较高,可为临床治疗提供指导。

Objective To explore the diagnostic value of two-dimensional three plane ultrasound combined with three-dimensional ultrasound(3DUS)for fetal cleft lip and palate.Methods With the selection of 8079 pregnant women(8135 fetuses)in the early and middle stages with systematic color ultrasound examination in the hospital from February 2020 to August 2023,they underwent two-dimensional three-plane ultrasound and 3DUS examination for preliminary screening of cleft lip and palate conditions.With the use of induced labor and postpartum facial results as the gold standard,the diagnostic value of two-dimensional three plane ultrasound,3DUS,and their combined examination for fetal cleft lip and palate was analyzed.Results Through induced labor and postpartum facial examination,129 fetuses(1.59%)with cleft lip and palate were detected in 8079 pregnant and postpartum women(8135 fetuses),including 20 cases with simple cleft palate,40 cases with cleft lip and palate,and 69 cases with cleft lip and palate.With the use of induced labor and postpartum facial results as the gold standard,the overall consistency rate of two-dimensional three plane ultrasound combined with 3DUS examination for cleft lip and palate was higher than that of examination alone,and the difference was statistically significant(P<0.05);The combination of two-dimensional three plane ultrasound and 3DUS in the examination of cleft lip and palate showed excellent consistency with the gold standard(Kappa=0.826).The specificity,accuracy,and positive predictive value of two-dimensional three plane ultrasound combined with 3DUS examination for cleft lip and palate were higher than those of examination alone,and the differences were statistically significant(P<0.05);There was no significant difference in sensitivity and negative predictive value between single and combined examination(P>0.05).Conclusion The combination of two-dimensional three plane ultrasound and 3DUS has a high diagnostic value for fetal cleft lip and can provide guidance for clinical treatment.