| 常 慧,韩 康,王 莉,刘彩宁,高全有,艾 虹.超声系统筛查在孕早期胎儿中枢神经系统先天畸形诊断的价值分析[J].,2018,(13):2588-2592 |
| 超声系统筛查在孕早期胎儿中枢神经系统先天畸形诊断的价值分析 |
| Value of Ultrasound System Screening in the Diagnosis of Congenital Malformations of Fetal Central Nervous System in Early Pregnancy |
| 投稿时间：2018-03-08 修订日期：2018-03-28 |
| DOI：10.13241/j.cnki.pmb.2018.13.040 |
| 中文关键词: 超声 孕早期 中枢神经系统 先天畸形 诊断价值 |
| 英文关键词: Ultrasound Early pregnancy Central nervous system Congenital malformation Diagnostic value |
| 基金项目:国家自然科学基金项目（81702935）；济南军区总医院院长基金项目（2015ZX01） |
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| 中文摘要: |
| 摘要 目的：探讨超声系统筛查在孕早期胎儿中枢神经系统先天畸形诊断的价值分析。方法：选取2014年3月～2017年4月来我院超声科行孕早期胎儿颈部透明层（Nuchal translucency, NT）筛查的孕妇2084例，胎儿共2135例。采用超声测量胎儿头臀长（Croen rump length,CRL）和颈部透明层（Nuchal translucency, NT）值，通过头胸部正中矢状断面、侧脑室水平横断面、小脑及后颅窝池断面、脊柱长轴断面等4个超声影像标准断面对孕早期胎儿的中枢神经系统解剖结构进行系统检查，统计各组在上述4个超声标准断面的检查显示情况及NT值，同时分析NT值、标准断面显示率与孕龄的关系，统计分析孕早期应用超声影像标准断面检查对中枢神经系统畸形的检出率、诊断敏感度、特异度、阳性预测值、阴性预测值。结果：孕早期胎儿采用超声检查，结果显示头胸部正中矢状断面、侧脑室水平横断面、小脑及后颅窝池断面、脊柱长轴断面的超声影像学显示率分别为98.17%、99.44%、98.78%和98.97%，不同孕龄组间超声断面显示率差异对比，x2检验值分别为0.25、1.65、0.62、0.13，差异无统计学意义（P>0.05）；孕早期超声诊断胎儿中枢神经系统畸形的敏感度为90.91%，特异度为100%，阳性预测值为100%，阴性预测值为99.48%；正常胎儿的NT值与其孕龄呈正相关（r=0.153）。结论：超声检查对孕早期胎儿中枢神经系统结构畸形的显示率较高，且不受胎儿孕龄影响。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the value of ultrasonic system screening in the diagnosis of congenital malformation of fetal central nervous system in early pregnancy. Methods: From March 2014 to April 2017, 2084 cases of pregnant women with fetal nuchal translucency in early pregnancy in our hospital were enrolled, including 2135 fetuses. The ultrasonic measurement of fetal crown rump length and nuchal translucency values through the head sagittal section, lateral ventricle, cross-sectional level of cerebellum and posterior cranial fossa, spine section 4 long axis cross sectional anatomy of the standard ultrasound fetal central nervous system structure in system inspection, statistical analysis and display the value of NT in the 4 section of the standard ultrasonic examination, and the analysis of the NT value and the standard section display rate and the relationship between gestational age and early pregnancy by ultrasound examination of the standard section of central nervous system abnormalities detection rate, sensitivity, specificity, positive predictive value and negative predictive value of statistical analysis. Results: The fetus in early pregnancy by ultrasonography, ultrasound imaging showed head chest median sagittal and lateral ventricle level transverse, cerebellum and posterior cranial fossa, spine section long axis cross study shows that rates were 98.17%, 99.44%, 98.78% and 98.97%, different groups of gestational age between ultrasonic section display rate difference contrast, x2 the test values were 0.25, 1.65, 0.62, 0.13, the difference was not statistically significant (P>0.05); early pregnancy ultrasound diagnosis of fetal malformation of the central nervous system's sensitivity was 90.91%, specificity was 100%, the positive predictive value was 100%, the negative predictive value was 99.48%; the NT value and the normal fetal gestational age was positively correlated (r=0.153). Conclusion: Ultrasonography has a higher display rate of fetal central nervous system structural malformations in early pregnancy, and is not affected by gestational age. |
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