二维和三维超声表面成像及断层显像技术对胎儿唇腭裂的诊断分析-影像医学与核医学专业论文.docxVIP

二维和三维超声表面成像及断层显像技术 对胎儿唇腭裂的诊断 研究生：马亚楠 导师：向红副教授 摘要 目的：应用三维超声技术,寻求准确而有效的诊断唇腭裂及评价腭部完整与否的 方法。方法：自 2009 年 4 月～2010 年 10 月到我院门诊就诊的 6558 例孕妇进行二维 及三维超声检查。应用二维超声进行胎儿颜面扫查,由同一操作者以胎儿颜面部正中 矢状切面为初始切面进行 3D/4D 采样。三维采样形成的容积数据库存入硬盘,由另一 操作者在未知二维诊断结果的前提下,利用 4Dview 软件进行脱机分析,与产后结果对 比并由 2 名医生共同回顾畸形胎儿的三维及二维超声图像。结果：6558 例孕妇中, 失访 231 例,有正常产或引产结果者 6327 例,已证实有唇腭裂者 34 例。二维超声诊 断单纯性唇裂灵敏度 92.30%,特异度 99.98%,阳性预测值 95.45％,三维表面成像诊断 单纯性唇裂灵敏度 100%,特异度 99.98%,阳性预测值 95.83％；两种方法诊断唇裂差 异性进行比较, χ2=0.53.84,P0.05,二者无统计学差异。二维超声诊断腭裂和唇裂合 并腭裂灵敏度 36.36%,特异度 100%,阳性预测值 100％,TUI 诊断腭裂和唇裂合并腭裂 灵敏度 90.91%,特异度 100%,阳性预测值 100％,两种方法诊断腭裂和唇裂合并腭裂差 异性进行比较, χ2=4.163.84, P0.05,有统计学意义。结论：三维表面成像与二维超 声比较，能够反映胎儿颜面畸形的表面形态、细节特征,对唇裂的诊断更加直观。TUI 能显示胎儿各个方向上的断层图像,图像的获取受操作者的技术经验、胎儿胎位等因 素影响相对较小,在一定程度上提高的胎儿腭裂的检查率。 关键词：二维超声； 三维超声； 断层超声显像技术； 唇腭裂 2D and 3D ultrasound surface imaging and tomography in the diagnosis of fetal cleft lip and palate Postgraduate: Ma ya-nan Supervisor: Prof.Xiang hong Abstract Objectives Using ultrasonic technology, to seek effective and accurate method of diagnosis of cleft lip and palate and evaluation jaws complete or not .Methods From April 2009 to October 2009, 6558 outpatient of pregnant women who received two-dimensional and three-dimensional ultrasound. First, using two-dimensional ultrasound to achieve fetus facial scanning, Second, to achieve 3D / 4D sampling with fetal face ministry midline sagittal cut-side for initial cut surface by the same operator. 3d sampling formation volume database deposited in the hard disk, By another operator in unknown two-dimensional diagnosis premise, Using 4DView Software pages 6.0 (GE are by telephone under 0120-2714540 Kretztechnik GmbH Co OHG) to offline analysis, Comparing the result with postpartum and by 2 doctors jointly review abnormalities fetus 3d and 2d ultrasound images. Results Of 6558 example women, 231 example was lost .6327 example had the normal production or odinopoeia. 35 patients of cleft lip and palate were confirmed. 34 cases obtained sat