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目的应用三维超声水平中心线法联合骨骼模式成像定位胎儿脊髓圆锥位置,探索脊髓圆锥位置随孕周的变化规律。方法选取420例正常胎儿,应用三维超声水平中心线法联合骨骼模式成像定位胎儿脊髓圆锥位置,分析胎儿脊髓圆锥对应椎体水平与孕周的相关关系;应用t检验进行耗时差异分析;应用Kappa检验进行可重复性分析。结果 (1)胎儿脊髓圆锥三维超声显示率为97.6%。(2)胎儿脊髓圆锥与孕周之间的线性回归方程为:Y=-6.446X+41.547(R=0.771,R2=0.594,P<0.001)。(3)二维超声组较三维超声组耗时平均多30s,95%可信区间0.96~0.82(P<0.001)。(4)二维与三维超声两种方式定位胎儿脊髓圆锥位置以及操作者间、操作者内定位胎儿脊髓圆锥一致性检验加权Kappa值分别为0.96、0.92、0.95。结论三维超声水平中心线法联合骨骼模式成像能够准确定位胎儿脊髓圆锥位置。
Objective To evaluate the location of the conus of the spinal cord with gestational age by using the three-dimensional ultrasound horizontal centerline method combined with skeletal imaging. Methods Forty-two normal fetuses were selected. The conus position of fetus spinal cord was determined by 3D horizontal center line method combined with skeletal pattern imaging. The correlation between fetal concentric vertebral level and gestational age was analyzed. T-test was used to analyze the time-consuming difference. Kappa Test for repeatability analysis. Results (1) Fetal spinal cord cone three-dimensional ultrasound showed a rate of 97.6%. (2) The linear regression equation between fetal conus and gestational age was Y = -6.446X + 41.547 (R = 0.771, R2 = 0.594, P <0.001). (3) Compared with three-dimensional ultrasound group, the two-dimensional ultrasound group took an average of 30s longer than the three-dimensional ultrasound group, with a 95% confidence interval of 0.96 to 0.82 (P <0.001). (4) Two-dimensional and three-dimensional ultrasound two ways to locate the conus fetal spinal cord position and operator, the operator concentric fetal spinal cord consistency test weighted Kappa values were 0.96,0.92,0.95. Conclusion Three-dimensional ultrasound horizontal centerline combined with skeletal imaging can accurately locate the fetal spinal conus position.