胎儿畸形诊断中实时三维超声表面及透明成像模式联合应用的临床价值.docVIP

胎儿畸形诊断中实时三维超声表面及透明成像模式联合应用的临床价值 　　[摘要]目的 探讨胎儿畸形诊断中实时三维超声表面及透明成像模式联合应用的临床价值。方法 选取2014年7月～2015年7月在我院接受二维、三维超声检查的202例孕妇作为研究对象，所有孕妇均已妊娠16～38周，通过三维超声表面及透明成像模式对胎儿进行诊断，分析计算二维、三维超声诊断的准确度、特异度和敏感度。结果 本研究共检出24处畸形，其中产前二维超声正确判断病变部位16处（66.67%），漏诊8处（33.33%）；三维超声正确判断病变部位21处（87.50%），漏诊3处（12.50%）。两者的诊断正确率比较，差异有统计学意义（P0.05）。在接受检查的202例孕妇中，通过出生和引产后证实有52例畸形，其中二维超声诊断出12例，无胎儿畸形190例，引产后或出生后有9例胎儿畸形，无畸形胎儿193例。采用三维超声诊断出16例胎儿畸形，无畸形胎儿186例，引产后或出生后有15例胎儿畸形，无畸形胎儿187例。二维超声诊断的敏感度较低，二维联合实时三维诊断的敏感度为90.35%，特异度为94.74%，准确度达到了100.00%。结论 实时三维超声表面及透明成像模式在诊断胎儿畸形中能弥补二维超声的不足，提高胎儿畸形的诊断准确率，在胎儿畸形产前诊断方面起着积极的促进作用，值得临床推广应用。 　　[关键词]胎儿畸形；三维超声表面；透明成像；影像 　　[中图分类号] R445.1 [文献标识码] A [文章编号] 1674-4721（2016）10（c）-0118-03 　　[Abstract]Objective To explore the clinical value of real-time three-dimensional ultrasound surface combined with transparency imaging mode in the diagnosis of fetal malformations.Methods 202 pregnant women who were given two-dimensional and three-dimensional ultrasound examination from July 2014 to July 2015 in our hospital were selected as the research objects，all pregnant women were pregnant for 16-38 weeks，and were diagnosed by three-dimensional ultrasound surface and transparent imaging.The accuracy，specificity and sensitivity of two-dimensional and three-dimensional ultrasound diagnosis were analyzed and calculated.Results 24 malformations were detected in this study，16 lesions （66.67%） were correctly diagnosed by two-dimensional ultrasound，8 lesions （33.33%） were missed diagnosis；21 lesions （87.50%） were correctly diagnosed by three-dimensional ultrasound，3 lesions （12.50%） were missed diagnosis.There was significant difference in the correct diagnosis rate between two-dimensional and three-dimensional ultrasound diagnosis （P 　　[Key words]Fetal malformation；Three-dimensional ultrasound surface；Transparent imaging；Image 　　目前临床上普遍采用超声对胎儿在母体宫内发育状况进行监测，以此判断和筛查胎儿是否畸形。虽然传统二维超声提供了二维切面图像，但胎儿体表结构的曲面改变较为复杂，二维超声难以辨认部分复杂的形态学改变，导致出现较高的误诊率和漏诊率。近年来，随着我国经济水平的提升，医学技术相对于以往也有了较大改善，三维超声的应用拓展了超声技术空间显像功能，为临床诊断提供