论文部分内容阅读
目的:探讨早孕期超声筛查胎儿开放性脊柱裂(open spine bifida,OSB)的方法,试图提早开放性脊柱裂诊断时间。材料与方法:选择300例正常胎儿按孕周分为11~11+6周、12~12+6周、13~13+6三组,每组100例,常规检查颈项透明层(NT)后,在此切面上测量胎儿颅内透明层(IT)厚度、脑干直径(BS)与脑干-枕骨间距离(BSOB),计算出BS/BSOB比值,并对测量值与比值进行统计,得出正常值范围。然后用测得的正常值,对3000例11~13+6孕周胎儿分别用IT、BS、BSOB和BS/BSOB进行OSB的诊断试验评价,并计算其特异性、敏感性、漏诊率、误诊率和Youden指数。结果:300例11~13+6孕周胎儿的正常参考值范围分别为:IT 1.3-2.3mm,BS 1.8-3.4mm,BSOB 3.0-5.8mm,BS/BSOB比值0.5-0.8。在诊断试验评价的3000例胎儿中经引产或新生儿随访证实为OSB共5例,用IT、BS、BSOB和BS/BSOB异常筛查OSB的情况为:IT 3/5例,BS 1/5例,BSOB 2/5例,BS/BSOB比值4/5例,其敏感性和特异性分别为60%/99.4%;20%/99.3%;40%/99.5%;80%/99.8%。结论:BS/BSOB比值>1.0是筛查早孕期胎儿OSB较敏感的指标。
OBJECTIVE: To explore the method of screening for open spine bifida (OSB) in early pregnancy by ultrasound to try to diagnose open spina bifida earlier. MATERIALS AND METHODS: Three hundred fetuses of normal fetus were divided into three groups according to gestational age: 11 ~ 11 + 6 weeks, 12 ~ 12 + 6 weeks and 13 ~ 13 + 6 groups, with 100 cases in each group. , Measuring the thickness of intracranial intracranial clear layer (IT), the diameter of brain stem (BS) and the distance between the brain stem and the occipital bone (BSOB) on this section, and calculating the ratio of BS / BSOB and calculating the measured value and the ratio Out of normal range. Then, the diagnostic test of OSB in 3000 cases of 11 ~ 13 + 6 gestational weeks fetuses with IT, BS, BSOB and BS / BSOB respectively was evaluated with the normal values measured, and its specificity, sensitivity, missed diagnosis rate, misdiagnosis Rate and Youden index. Results: The normal reference range of 300 fetuses from 11 to 13 + 6 gestational weeks were: IT 1.3-2.3mm, BS 1.8-3.4mm, BSOB 3.0-5.8mm and BS / BSOB 0.5-0.8. Among the 3000 fetuses diagnosed by diagnostic tests, 5 were confirmed as OSB by induction or neonatal follow-up. The abnormality of OSB screening by IT, BS, BSOB and BS / BSOB were: IT 3/5 cases, BS 1/5 For example, there are 2/5 cases of BSOB and 4/5 cases of BS / BSOB. The sensitivity and specificity are 60% / 99.4%, 20% / 99.3%, 40% / 99.5% and 80% / 99.8% respectively. Conclusion: The BS / BSOB ratio> 1.0 is a sensitive index for detecting OSB in early pregnancy.