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目的分析比较产前超声和MRI在胎儿先天性膈疝诊断中的价值。方法分析75例胎儿膈疝的产前超声、MRI特征,并计算产前超声和MRI检查诊断符合率,对判断肝脏有无疝入胸腔的比较采用χ~2检验。结果产前超声诊断了73例,漏诊2例,诊断符合率97.3%;产前MRI诊断了74例,漏诊1例,诊断符合率98.7%。24例胎儿肝脏疝入胸腔,产前超声诊断15例,漏诊9例,误诊1例;MRI诊断23例,漏诊1例。MRI在判断先天性膈疝胎儿是否有肝脏疝入胸腔的诊断上优于产前超声检查,差异具有统计学意义(χ~2=4,P<0.05)。结论产前超声能够较准确的诊断胎儿先天性膈疝,是胎儿常规筛查的首选,对于超声诊断困难的肝脏疝入的先天性膈疝胎儿,MRI明显减少了漏误诊。
Objective To compare the value of prenatal ultrasound and MRI in the diagnosis of fetal congenital diaphragmatic hernia. Methods Prenatal ultrasound and MRI features of 75 cases of fetal diaphragmatic hernia were analyzed. The coincidence rate of prenatal ultrasound and MRI examination was calculated. The χ ~ 2 test was used to compare the presence or absence of herniation into the thorax in the liver. Results Prenatal ultrasound diagnosis of 73 cases, 2 cases of missed diagnosis, the diagnostic accuracy rate of 97.3%; prenatal MRI diagnosis of 74 cases, 1 missed diagnosis, the diagnostic coincidence rate of 98.7%. 24 cases of fetal liver hernia into the chest, prenatal diagnosis of 15 cases of ultrasound, missed diagnosis in 9 cases, 1 case of misdiagnosis; MRI diagnosis of 23 cases, 1 case of missed diagnosis. MRI is superior to prenatal ultrasound in the diagnosis of congenital diaphragmatic hernia in the thorax of the fetus, the difference was statistically significant (χ ~ 2 = 4, P <0.05). Conclusion Prenatal ultrasound can diagnose fetal congenital diaphragmatic hernia more accurately and is the first choice for routine fetal screening. For fetuses with congenital diaphragmatic hernia admitted to the liver with difficult sonographic diagnosis, prenatal ultrasound significantly reduces misdiagnosis.