| 摘要: |
| 目的：探讨基层医院超声和磁共振（MRI）检查技术在产前诊断胎儿闭合性脊柱裂的价值。方法：选择26例临床确诊的闭合性脊柱裂胎儿作为研究组，38例不合并神经系统畸形的胎儿作为对照组，回顾性分析研究组和对照组产前超声、MRI和联合检查三种检查方式诊断结果，对比不同检查方式的诊断效能。结果：产后临床诊断闭合性脊柱裂26例患儿中，产前准确诊断闭合性脊柱裂24例，超声诊断20例，MRI诊断17例，联合诊断24例，漏诊2例（1例脊髓拴系和1例皮毛窦）。超声、MRI和超声联合MRI三种方法诊断闭合性脊柱裂的敏感度、特异度、阳性预测值、阴性预测值、准确率存在差异，差异有统计学意义（P<0.05）。三种方法的ROC曲线下面积分别为0.8964、0.8757、0.9120，差异有统计学意义（P<0.05）。结论：在基层医院超声作为首选的检查方式用于诊断胎儿闭合性脊柱裂，MRI可作为补充检查方式，二者联合检查能更有效检出胎儿闭合性脊柱裂。 |
| 关键词: 超声，MRI，闭合性脊柱裂，脊髓圆锥 |
| DOI： |
| 投稿时间：2023-02-20修订日期：2023-03-22 |
| 基金项目: |
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| Comparison of prenatal ultrasound and MRI in the examination of fetal closed spina bifida in primary hospitals |
| zhenjinghua |
| () |
| Abstract: |
| Objective: To investigate the value of ultrasound and magnetic resonance imaging (MRI) in prenatal diagnosis of fetal spina bifida closed.Methods: A total of 26 fetuses with clinically confirmed closed spina bifida were selected as the study group, and 38 fetuses without nervous system abnormalities were selected as the control group. The diagnostic results of prenatal ultrasound, MRI and combined examination were retrospectively analyzed in the study group and the control group. The sensitivity and specificity of different examination methods were compared, and the efficiency was checked by comparing the area under the ROC curve. Results: 26 cases of spina bifida were diagnosed clinically after delivery, 24 cases were diagnosed accurately before delivery, 20 cases were diagnosed by ultrasound, 17 cases were diagnosed by MRI, 24 cases were diagnosed by combined diagnosis, 2 cases were missed diagnosis（1 case of tethered cord and 1case of furicular sinus）. There were significant differences in sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the three methods in the diagnosis of closed spina bifida (P<0.05). The areas under ROC curves of the three methods were 0.8964, 0.8757 and 0.9120, respectively, and the differences were statistically significant (P<0.05). Conclusion: Ultrasound can be used as the first examination for the diagnosis of fetal spina bifida in primary hospitals, MRI as a supplementary examination, the combination of the two examination can be more effective in the detection of fetal spina bifida. |
| Key words: Ultrasound, MRI, Closed spina bifida, Medullary cone |
