四维超声和MRI在胎儿隐性脊柱裂筛查中的应用及影响诊断准确性的因素分析

目的:探讨四维超声在胎儿隐性脊柱裂筛查中的应用及影响诊断准确性的因素分析.方法:选择在医院进行产前筛查,经普通超声检查疑似存在胎儿脊柱发育异常且不能被明确诊断的80名孕妇,分别采用四维超声和磁共振成像(MRI)检查,比较四维超声和MRI诊断方法诊断胎儿隐性脊柱裂的效果,分析影响四维超声诊断准确性的影响因素.结果:四维超...

The application of 4D ultrasound and MRI in the screening of spina bifida occulta and the analysis of the factors of affecting diagnostic accuracy

Objective:To explore the application of four-dimensional(4D)ultrasound in the screening of spina bifida occulta and the analysis of the factors that affected diagnostic accuracy.Methods:80 pregnant women whose fetuses with suspected spine dysplasia couldn’t be confirmed and who underwent prenatal screening and general ultrasonic examination were selected.And the 4D ultrasound and magnetic resonance imaging(MRI)were adopted respectively.The effects of diagnosing spina bifida occulta of fetuses between 4D ultrasound and MRI were compared,and the influence factors that affected the diagnostic accuracy of 4D ultrasound were further analyzed.Results:The diagnostic consistencies between 4D ultrasound examination and follow-up result,and between MRI examination and followup result were better respectively(Kappa=0.915,Kappa=0.926).The differences of sensitivity,specificity and accuracy in diagnosing spina bifida occulta of fetuses between 4D ultrasound and MRI were no significant,respectively.And the difference of the examination result of receiver operating characteristic(ROC)curve in diagnosing spina bifida occulta between two examination methods was no significant.And the multiple results indicated that the body mass index(BMI)of mother,gestational age,the place of focus and the biparietal diameter were independent factors that affected the diagnosis of 4D ultrasound for spina bifida occulta(OR=1.005,OR=3.600,OR=2.441,OR=1.901,P<0.05).Conclusion:The 4D ultrasound diagnosis has series advantages included high sensitivity,high accuracy and convenient operation in diagnosing spina bifida occulta of fetus.And the improved accuracy of 4D ultrasound for spina bifida occulta can achieve the purpose of eugenics.