| 摘要: |
| 目的 测量妊娠23-24周胎儿三维容积超声部分肢体体积,和常规二维超声参数比较,探讨对预测晚发型生长受限(fetal growth restriction,FGR)的应用价值。方法 选取2018年1月至2019年12月在我院行产前检查并最终确诊为晚发型FGR的74例孕妇,定义为病例组,另选取同期正常孕妇200例为对照组。在超声诊断仪规范化测量妊娠23-24周胎儿二维超声参数：双顶径、头围、腹围、股骨长度,记录二维超声参数生成的胎儿体重(estimated fetal weight,EFW)。三维容积超声测量部分肢体体积：上臂中段50%的体积(fractional arm volume, AVol)和大腿中段50%的体积(fractional thigh volume,TVol)。比较二组各个数值差异,应用ROC曲线下面积AUC比较各个参数预测晚发型FGR的价值。结果 病例组和对照组的双顶径、头围、腹围、股骨长度及EFW无统计学差异。两组间的AVol和TVol比较差异有统计学意义。ROC曲线分析显示,AVol和TVol预测晚发型FGR的曲线下面积(AUC)为0.70和0.74,二者差异无统计学意义,最佳截断值分别为4.5 mL和9.4 mL,,预测晚发型FGR的敏感性、特异性、准确性分别为63.5%和69.4%、89.4%和88.1%、81.4%和83.2%。二者联合预测晚发型FGR敏感性、特异性和准确率分别为79.0%、94.8%和90.1%。 |
| 关键词: 三维超声 胎儿生长受限 ROC曲线 |
| DOI： |
| 投稿时间：2020-01-11修订日期：2020-01-22 |
| 基金项目: |
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| Late-onset fetal growth restriction prediction using fractional limb volume obtained with 3D ultrasound at 23-24 weeks of gestation |
| Qin jia-yun,zhao xin-mei,wu chun-yan,li yin,ma jin-qi,qian li,dingyan |
| () |
| Abstract: |
| 2.Department of Medical Ultrasound, Wuxi People’s Hospital of Nanjing Medical University,Wuxi China#$NL ：Objective To validate the use of fractional limb volume obtained with 3D ultrasound for predicting late-onset fetal growth restriction (FGR) at 23-24 weeks of gestation by comparing with conventional 2D ultrasound. Methods A total of 74 pregnant women diagnosed with late-onset FGR in our hospital from January 2018 to December 2019 were selected into the case group, and 200 normal pregnant women were included as the control group. Measurements were performed at 23-24 weeks of gestation using 2D ultrasound for standard fetal biometry (double parietal diameter, head circumference, abdominal circumference, femur length and ultrasound-estimated fetal weights (EFW)), and 3D ultrasound for fractional arm volume (AVol) on 50% of the humeral diaphysis length and fractional thigh volume (TVol) on 50% of the femoral diaphysis length. The resulting areas under the ROC curves (AUC) were compared the parameters of the two groups for predicting the late-onset FGR. Results There were no significant differences in terms of double parietal diameter, head circumference, abdominal circumference, femur length and EFW, and statistically differences in AVol and TVol between the two groups. ROC analysis showed that the AUC values in predicting by AVol and TVol for late-onset FGR was 0.70 and 0.74, respectively. No significant differences were found between groups. The optimal cutoff values were 4.5 mL and 9.4 mL, respectively. The sensitivity, specificity and accuracy of predicting late-onset FGR of the two groups were 63.5% and 69.4%, 89.4% and 88.1%, 81.4%, and 83.2%, respectively. The sensitivity, specificity and accuracy in combined prediction of late-onset FGR were 79.0%, 94.8%, and 90.1%, respectively. Conclusions Fractional limb volume (AVol and TVol) assessment may improve the late-onset FGR prediction at 23-24 weeks of gestation. |
| Key words: 3D ultrasound fetal growth restriction ROC curve |
