MRI联合血清甲胎蛋白检测诊断胎儿神经系统异常的研究

目的显示MRI在诊断胎儿神经系统异常中的优势,及探讨MRI联合AFP在胎儿神经系统异常的价值。方法对2011年1月～2012年5月在我院门诊及住院行产前胎儿B超及宫内MRI检查的孕妇,其中B超显示神经系统正常的有30例,B超提示神经系统异常的30例,两者均行血清AFP检查,B超提示异常的孕妇行MRI检查,对妊娠结局进行随访。比较分析B超、磁共振及磁共振联合血清甲胎蛋白检测对胎儿神经系统畸形诊断准确性。结果 （1）血清甲胎蛋白在正常胎儿与胎儿神经系统畸形的结果比较差异有统计学意义（P〉0.05）;（2）产前胎儿超声与核磁共振诊断准确率、假阳性率、假阴性比较差异有统计学意义（χ2=3.41-6.23,P〈0.05）;（3）磁共振与磁共振联合血清甲胎蛋白检测比较,诊断准确率差异无统计学意义。结论核磁共振成像技术在诊断胎儿神经系统异常的临床应用中较胎儿超声更具优越性,可提供更准确的脑实质信息,以减少误诊所致不必要的引产。

Diagnosis of abnormalities of fetal nervous system by using MRI imaging and detection of serum alpha-fetoprotein

Objective To investigate the value of MRI imaging and detection of serum alpha-fetoprotein in diagnosis of abnormalities of fetal nervous system. Methods Thirty pregnant women with normal nervous system and 30 pregnant women with abnormal nervous system by ultrasound and MRI in the Affiliated Hospital of Hainan Medical College from Juanurary 2011 o May 2012 were collected for AFP test. The pregnant women with abnormal nerous system by ultrasound were reexamined by using MRI. e results were compared. Results The levels of AFP in normal and abnormal fetus of nervous sstem were statistically differnet （P〉 0.05） The accurate diagbnosis rate, false positive, rate and false negative rates of ultrasound and MRI in diagnosis of prenatal fetus were statistically different （X^2=3.41-6.23, P〈 0.05）. There was no statistical difference in the rates of accurate diagnosis by MRI and MRI incombination with detection of alpha-fetoprotein.Conclusiorl MRI imaging technology is superior to ultrasound in diagnosis of fetus with abnormal nervous system as it can provide accuarte brain of the clinical application of fetal ultrasound is more advantages, and it can provide more accurate information of brain parenchyma and reduce misdiagnosis rate.and abortion rate