摘要
目的探究彩色多普勒超声在不同孕周产前胎儿肢体畸形诊断中的应用价值。方法选取2019年1月~2019年12月进行产前胎儿肢体畸形筛查的200例孕妇,根据孕周分组,将65例孕11~13+6W的孕妇作为孕早期组,将72例孕14~27+6W的孕妇作为孕中期组,将63例孕28~40+6W的孕妇作为孕晚期组。观察三组彩色多普勒超声筛查结果,并以引产后病理结果或出生结果作为金标准,计算产前超声筛查的灵敏度、特异度,Kappa检验超声与金标准的一致性。结果孕早期筛查准确率为83.33%,孕中期筛查准确率为100.00%,孕晚期筛查准确率为100.00%。孕早期5例肢体畸形:1例左前臂缺失,1例右手截肢畸形,3例肢体—体壁综合征。孕中期12例肢体畸形:2例尺桡骨发育不良,2例足内翻,2例成骨发育不全,1例人鱼序列综合征,1例裂手畸形,1例左手多指畸形,3例肢体—体壁综合征。孕晚期6例肢体畸形:1例桡骨缺失并钩状手,3例四肢长骨短小,2例足内翻。产前超声筛查敏感度为95.65%,特异度为100.00%,彩色多普勒超声与引产后病理结果或出生结果的Kappa值是0.892,一致性较好。结论孕早中晚期孕妇进行彩色多普勒超声筛查,可准确检出胎儿肢体畸形,降低胎儿先天性发育不良发生率。
Objective To analyze of the application value of color Doppler ultrasound in diagnosis of prenatal fetal limb deformity.Methods 200 pregnant women who were screened for prenatal fetal limb deformity from January 2019 to December 2019 in the ultrasound department of our hospital were selected.According to the gestational week group,65 pregnant women with 11~13+6 W pregnancy were selected as the early pregnancy group,72 pregnant women with 14~27+6 W pregnancy were taken as the second trimester group,and 63 pregnant women with 28~40+6 W pregnancy were taken as the second trimester group.The three groups of color Doppler ultrasound screening results were observed,and the postpartum pathological results or birth results were used as the gold standard.The sensitivity and specificity of the prenatal ultrasound screening were calculated.Kappa was used to check the consistency of the ultrasound and gold standards.Results The accuracy rate of screening in early pregnancy was 83.33%,the accuracy rate of screening in the second trimester was 100.00%,and the accuracy rate of screening in the third trimester was 100.00%.In the first trimester,5 cases of limb deformity included 1 case of missing left forearm,1 case of right hand amputation,and 3 cases of limb-body wall syndrome.Twelve cases of limb malformations in the second trimester included 2 cases of ulnar and radius dysplasia,2 cases of varus varus,2 cases of osteogenesis hypoplasia,1 case of mermaid sequence syndrome,1 case of split hand deformity,1 case of left hand polydactyly,3 case of limb-Body wall syndrome.Six cases of limb malformation in the third trimester included 1 case with missing radius and hooked hand,3 cases with short long bones in the extremities,and 2 cases with foot inversion.Prenatal ultrasound screening had a sensitivity of 95.65%and a specificity of 100.00%.The Kappa value of color Doppler ultrasound and post-laboratory pathological results or birth results was 0.892,which was in good agreement.Conclusion Color Doppler ultrasound screening in early,middle and late pregnancy can accurately detect fetal limb deformities and reduce the incidence of fetal congenital dysplasia.
作者
王蕾
丁艳
王静
WANG Lei;DING Yan;WANG Jing(Department of Special Examination, Qingdao Women and Children Hospital, Qingdao 266000, P.R.China;Department of Ultrasound, Maternal and Child Health Care and Family Planning Service Center, Shibei District, Qingdao 266000, P.R.China)
出处
《医学影像学杂志》
2020年第11期2060-2064,共5页
Journal of Medical Imaging
关键词
彩色多普勒超声
产前筛查
肢体畸形
尺桡骨发育不良
钩状手
肢体—体壁综合征
四肢短小
Color Doppler ultrasound
Prenatal screening
Limb deformity
Ulnar and radius dysplasia
Hooked hand
Limb-body wall syndrome
Short upper limbs
