连续顺序追踪超声法检测胎儿肢体畸形

Prenatal ultrasonographic evaluation of fetal limbs anatomy and fetal limbs malformations using a systematic continuous sequence approach

目的 探讨连续顺序追踪超声法 (SCSA)在诊断胎儿肢体畸形中的价值。方法 应用彩色多普勒超声仪 ,对 2 0 0 0年 8月～ 2 0 0 2年 9月在我院产前检查的 4 932例孕妇 ,行胎儿肢体SCSA检测 ,观察胎儿肢体形态、结构、姿势、运动等异常。结果 4 932例中 ,4750例 (96 3 % )完整显示胎儿四肢骨性结构的长轴与短轴切面。SCSA检出 34例 ,1 9种 98处 (87 2 % )胎儿肢体畸形 ,经产后证实的各种肢体畸形 39例 ,1 0 0条肢体受累 ,涉及畸形 2 8种 1 1 4处。SCSA诊断胎儿肢体畸形的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为 87 2 % ,99 8% ,99 2 % ,81 0 % ,99 9%。

Objective To review the value of ultrasonographic evaluation on fetal limbs anatomy and malformations in prenatal diagnosis using a systematic continuous sequence approach(SCSA) Methods Successive 4 932 prenatal ultrasonographic evaluation during gestation aging 14-40 weeks from August 2000 to September 2002 entered the present review SCSA was applied to scan each limb of the fetus respectively Results The anatomic structures of the four limbs of the fetus were clearly displayed and correctly recognized on ultrasonic images using the SCSA in 4 750 cases (96 3%) Ninety eight limb malformations of 34 fetuses were correctly diagnosed(87 2%) Whereas 16 malformations of 5 fetuses were missed to recognize(12 8%) The diagnoses were confirmed after subsequent labor or induced labor The sensitivity, specificity, accuracy, positive and negative predictive values were 87 2%,99 8%,99 2%,81 0 % and 99 9%, respectively Conclusion The majority of fetal limb structures and malformations can be clearly demonstrated on prenatal ultrasonic imaging using SCSA SCSA for prenatal ultrasonographic evaluation of the fetal limbs is a reliable and accurate diagnostic modality so far as the skills become more sophisticated