摘要
目的探讨核磁共振(MRI)联合超声(US)与染色体微阵列分析技术(chromosomal microarry analysis,CMA)在中枢神经系统异常胎儿产前诊断中的应用。方法选取我院接受治疗的226例怀疑中枢神经系统异常胎儿的孕妇为此次观察的对象,所有孕妇胎儿均接受MRI联合US与CMA进行相关的检查。比较在不同检查方法下对于胎儿中枢神经系统异常的检出率、灵敏度以及特异度,比较异常胎儿在每种检查下的影像学图像表现。结果MRI检查在视野、分辨率、组织特异性以及脑沟、裂、回的图像都要比US检查的质量要高(P<0.05),而血流显示以及脉络丛室管膜的显示要比US检查的质量要低(P<0.05);总体来看MRI检查(91.50%)对中枢神经系统出现异常的总检出率要比US检查(87.17%)的高,两者联合检查的灵敏度、特异度分别为91.04%、21.43%;神经系统出现异常的226例胎儿中,经CMA检测其中有13例检测出染色体核型异常(6.77%),41例检查出CNVs(21.35%),包括24例致命性CNVs(12.50%),13例胎儿检查出VOUS(6.77%);其中11例选择了继续妊娠分娩,2例选择了引产,可见有选择继续妊娠的比例为84.62%。结论MRI联合US与CMA能够较为准确地诊断产前中枢神经系统异常胎儿,特别是对于在超声结构检查异常的胎儿,结合MRI能够更加有效的于产前对中枢神经系统异常胎儿进行诊断,值得临床推广。
Objective To explore the application of MRI combined with ultrasound and chromosome microarray analysis in the prenatal diagnosis of abnormal fetuses in the central nervous system.Methods We selected 226 pregnant women suspected of abnormal central nervous system fetuses treated in our hospital from december 2017 to november 2019 as the subjects of this study.All pregnant fetuses received MRI combined US and related examinations with CMA.The detection rate,sensitivity and specificity of fetal central nervous system abnormality under different examination methods were compared.Results The visual field,resolution,tissue specificity and the quality of the sulcus,fissure and gyrus of the MRI examination were higher than those of the US examination(P<0.05),while the quality of the blood flow and choroid plexus ventricular membrane was lower than that of the US examination(P<0.05);Overall,the overall detection rate of MRI examination(91.50%)for central nervous system abnormalities was higher than that of US examination(87.17%),and the sensitivity and specificity of the combined examination were 91.04%and 21.43%;Of the 226 fetuses with neurological abnormalities,13 with chromosomal karyotype abnormalities were detected by CMA(6.77%),41 with CNVs(21.35%),including 24 fatal VOUS(6.77%),13 abnormal central nervous system fetuses were detected,11 continued pregnancies were selected,and induced labor was selected in 2 cases.Conclusion MRI combined US and CMA can more accurately diagnose the abnormal fetus of the central nervous system,especially for the fetus with abnormal ultrasound structure examination,combined with MRI and CMA can more effectively diagnose the abnormal fetus of the central nervous system in prenatal,which is worthy of clinical promotion.
作者
王利顺
王启臣
张国梁
聂红艳
李刚
白力伟
华天书
WANG Lishun;WANG Qichen;ZHANG Guoliang;NIE Hongyan;LI Gang;BAI Liwei;HUA Tianshu(Department of Radiology, Qinhuangdao Maternal and Child Health Hospital, Qinhuangdao 066000, P.R.China;Department of Ultrasound, Qinhuangdao Maternal and Child Health Hospital, Qinhuangdao 066000, P.R.China;Operation Room of Qinhuangdao Maternal and Child Health Hospital, Qinhuangdao 066000, P.R.China;Prenatal Diagnosis Center of Qinhuangdao Maternal and Child Health Hospital, Qinhuangdao 066000, P.R.China;Genetic Eugenics Laboratory of Qinhuangdao Maternal and Child Health Hospital, Qinhuangdao 066000, P.R.China)
出处
《医学影像学杂志》
2021年第1期16-19,24,共5页
Journal of Medical Imaging
基金
河北省秦皇岛市科学技术研究与发展计划项目(编号:201703A130)。
关键词
磁共振成像
超声检查
染色体微阵列分析技术
中枢神经系统异常
胎儿
Magnetic resonance imaging
Ultrasound
Chromosomal microarray analysis
Central nervous system abnormality
Fetal
