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产科超声在筛查胎儿神经系统畸形中的价值。

The Value of Obstetric Ultrasound in Screening Fetal Nervous System Malformation.

机构信息

Department of Electrical Diagnosis, Jilin Province FAW General Hospital, Changchun City, Jilin Province, China.

Department of Geratology, The First Hospital of Jilin University, Changchun City, Jilin Province, China.

出版信息

World Neurosurg. 2020 Jun;138:645-653. doi: 10.1016/j.wneu.2020.01.014. Epub 2020 Jan 10.

Abstract

BACKGROUND

The article uses ultrasound imaging standard section to examine the fetal central nervous system (CNS) in early pregnancy, combined with ultrasound imaging in the diagnosis of fetal CNS malformation in the middle and late pregnancy, to determine the feasibility of ultrasound imaging in the detection of CNS abnormalities in the first trimester of the fetus.

METHODS

The article selected 2701 pregnant women from the Department of Ultrasound in our hospital from November 2012 to November 2016 to screen for the transparent layer of the fetal neck in early pregnancy, with a total of 2751 cases. The article uses Madison V20 and Madison XG color Doppler ultrasound diagnostic instruments, the probe frequency is measured from 2.0-3.5 MHz, grouped according to gestational age, the statistical section of the case is displayed, and the transparent layer of the neck value is used to count the ultrasound image during early pregnancy. The detection of the CNS malformation by the standard section examination and the sensitivity, specificity, positive predictive value, and negative predictive value of the diagnosis may affect the cause of the CNS display rate.

RESULTS

The sensitivity, specificity, positive predictive value, and negative predictive value of the ultrasound standard section in the diagnosis of fetal CNS malformation in early pregnancy were 85.7%, 100%, 100%, and 99.9%, respectively. Through research, it is found that the use of ultrasound imaging standard section can effectively diagnose fetal CNS severe deformity in early pregnancy, and the detection rate of CNS malformation in early pregnancy is 85.7%. At the same time, the number of positive cases and CNS malformations in this group were few.

CONCLUSIONS

The positive cases detected in early pregnancy were severe malformations of the CNS. The diagnosis of other CNS malformations in the fetus needs further study.

摘要

背景

本文采用超声影像标准切面检查早孕期胎儿中枢神经系统(CNS),并结合中晚期妊娠超声影像诊断胎儿 CNS 畸形,探讨超声影像在早孕期检测胎儿 CNS 异常的可行性。

方法

本文选取我院超声科 2012 年 11 月至 2016 年 11 月期间 2701 例孕妇进行早孕期胎儿颈项透明层(NT)筛查,共 2751 例。采用麦迪逊 V20、麦迪逊 XG 彩色多普勒超声诊断仪,探头频率为 2.0-3.5MHz,按孕周分组,显示病例的统计切面,计数早孕期颈项透明层的超声影像。并通过标准切面检查对 CNS 畸形的检出率及诊断的灵敏度、特异度、阳性预测值、阴性预测值可能影响 CNS 显示率的原因进行分析。

结果

早孕期胎儿 CNS 畸形的超声标准切面诊断灵敏度、特异度、阳性预测值、阴性预测值分别为 85.7%、100%、100%、99.9%。通过研究发现,超声影像标准切面在早孕期能有效诊断胎儿 CNS 严重畸形,早孕期 CNS 畸形检出率为 85.7%,同时该组阳性病例及 CNS 畸形数量较少。

结论

早孕期检出的阳性病例均为 CNS 严重畸形,对胎儿其他 CNS 畸形的诊断还需进一步研究。

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