超声评分法鉴别诊断胎儿肾积水的临床价值

Clinical value of ultrasound scoring method in differential diagnosis of fetal hydronephrosis

目的:探讨超声评分法诊断胎儿肾积水的临床价值。方法:对肾积水胎儿进行超声检查,将PAPD、肾实质厚度和肾盂肾盏形态分别进行超声评分并累计每个肾的总评分。根据随访结果将肾积水胎儿分为生理组和病理组,绘制超声评分法两组肾积水的操作者特征(ROC)曲线。结果:98例共108个肾积水,其中79个(78.80%)为生理性,29个(21.20%)为病理性。对于诊断胎儿病理性肾积水,ROC曲线显示超声评分法鉴别诊断肾积水曲线下面积96.4%,其取值6时为诊断病理性肾积水最佳截断值,灵敏性81%,特异性94%。结论:超声评分法可用于临床鉴别诊断胎儿生理性与病理性肾积水。

Objective:To investigate the clinical value of ultrasound scoring method in diagnosis of fetal hydronephrosis.Methods:Ultrasound examination used in diagnosis of fetal hydronephrosis can provide ultrasound score of PAPD,thickness of renal parenchyma and renal pelvis morphology,then cumulative total score of each kidney.According to the results of follow-up,fetal hydronephrosis can be divided into the physiological groups and the pathology group,and rendering receiver operating characteristic(ROC) curve of hydronephrosis in two groups.Results:A total of 98 patients with 108 hydronephrosis,79 of them(78.80%) were physiological,while 29(21.20%) were pathological.For the diagnosis of fetal pathological hydronephrosis,ultrasound score Roc curve shows the area under the curve of differential diagnosis of hydronephrosis in 96.4%,the value of 6 is the optimal cut-off value for the diagnosis of pathological hydronephrosis,while the sensitivity is 81%,and the specificity is 94%.Conclusion:Ultrasound scoring method can be used in differential diagnosis of fetal physiological and pathological hydronephrosis.