Li Yang, Pan Ming-Zhi, Tao Guo-Wei, Ma Zhe, Wu Hai-Fang, Li Qi
Maternal and Child Health Care of Shandong Province, Key Laboratory of Birth Regulation and Control Technology of National Health and Family Planning Commission of China, Key Laboratory for Improving Birth Outcome Technique, Shandong Provincial Family Planning Institute of Science and Technology, Jinan, China.
Qilu Hospital of Shandong University, Jinan, China.
J Matern Fetal Neonatal Med. 2020 Jul;33(14):2372-2376. doi: 10.1080/14767058.2018.1551349. Epub 2019 Jan 4.
Recently, microcephaly has usually been misdiagnosed only by ultrasound measurement of head circumference (HC). Therefore, the aim of this study is to find another diagnostic index to supplement the original diagnostic method of microcephaly, to improve the detection rate of fetal microcephaly and to reduce the misdiagnosis rate. We retrospectively analyzed 123 pregnant women from February 2012 to January 2017 with fetal HC less than two standard deviations (SD). The facial profile line (FPL) was determined by ultrasonography. The first method (M1) was only used HC to determine whether the fetus was microcephaly, the second one (M2) was to combine HC and FPL for the diagnosis of microcephaly. Results were classified into five orderly categories by experienced sonographers. ROC curve was drawn to evaluate the diagnostic effect. Among the pregnant women, 14 cases of fetal head circumference were less than 3SD, 109 were -2SD < HC≤ -3SD. A total of 12 cases were confirmed of microcephaly by magnetic resonance imaging (MRI) or postnatal, 10 cases of HC were less than 3SD, 2 were -2SD < HC≤ -3SD. The area under the ROC curve for M1 and M2 were 0.751 and 0.983 respectively. The HC in combination with FPL can be used to evaluate the fetal HC and forehead development quickly, and to improve the sensitivity and specificity of diagnosing fetal microcephaly.
最近，小头畸形通常仅通过超声测量头围（HC）被误诊。因此，本研究的目的是寻找另一种诊断指标来补充小头畸形的原始诊断方法，以提高胎儿小头畸形的检出率并降低误诊率。我们回顾性分析了2012年2月至2017年1月123例胎儿HC小于两个标准差（SD）的孕妇。通过超声检查确定面部轮廓线（FPL）。第一种方法（M1）仅使用HC来确定胎儿是否为小头畸形，第二种方法（M2）是将HC和FPL结合用于小头畸形的诊断。由经验丰富的超声检查人员将结果分为五个有序类别。绘制ROC曲线以评估诊断效果。在这些孕妇中，14例胎儿头围小于3SD，109例为-2SD＜HC≤-3SD。共有12例经磁共振成像（MRI）或出生后确诊为小头畸形，10例HC小于3SD，2例为-2SD＜HC≤-3SD。M1和M2的ROC曲线下面积分别为0.751和0.983。HC与FPL结合可快速评估胎儿HC和前额发育情况，提高诊断胎儿小头畸形的敏感性和特异性。
