影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (3): 606-609.DOI: 10.7517/issn.1674-0475.211207

• 综述与论文 • 上一篇    下一篇

核磁共振评估胎儿中枢神经系统及椎体发育情况

张泳1, 王旭2   

  1. 1. 石家庄市第四医院, 河北 石家庄 050000;
    2. 河北中医学院, 河北 石家庄 050200
  • 收稿日期:2021-12-20 出版日期:2022-05-15 发布日期:2022-05-27

Evaluation of Fetal Central Nervous System and Vertebra Development by MRI

ZHANG Yong1, WANG Xu2   

  1. 1. The Fourth Hospital of Shijiazhuang, Shijiazhuang 050000, Hebei, P. R. China;
    2. Hebei University of Chinese Medicine, Shijiazhuang 050200, Hebei, P. R. China
  • Received:2021-12-20 Online:2022-05-15 Published:2022-05-27

摘要: 本研究探讨产前采用磁共振成像(MRI)技术诊断胎儿中枢神经系统及椎体发育畸形的临床价值。选取初步诊断怀疑胎儿中枢神经系统及椎体发育畸形的336例孕妇进行临床研究,所有孕妇均进行MRI扫描及彩超检查,以分娩或终止妊娠后胎儿病理学检查结果作为金标准,分析MRI在产前筛查诊断胎儿中枢神经系统及椎体发育畸形中的价值。MRI与产前彩超诊断胎儿各种类型的中枢神经系统发育畸形符合率比较,差异无统计学意义(P>0.05),但诊断的总体符合率高于产前彩超(P<0.05);MRI中枢神经系统畸形的灵敏度为87.50%、特异度为86.36%、ROC曲线下面积(AUC)为0.869;彩超诊断胎儿中枢神经系统畸形的灵敏度为69.44%、特异度为81.82%、AUC为0.756;MRI诊断脊柱侧弯的符合率高于彩超(P<0.05),MRI诊断胎儿椎体畸形的灵敏度为86.36%、特异度为97.45%、AUC为0.919;彩超的灵敏度为50.00%、特异度为81.53%、AUC为0.658。MRI技术诊断胎儿中枢神经系统及椎体发育畸形较产前彩超具有明显的优势。

关键词: 磁共振成像, 诊断, 胎儿, 中枢神经系统, 椎体, 畸形

Abstract: This study investigated the clinical value of prenatal magnetic resonance (MRI) technology in the diagnosis of fetal central nervous system and vertebral malformations. Selected 336 pregnant women with suspected fetal central nervous system and vertebral malformations for clinical research. All pregnant women underwent MRI scans and color Doppler ultrasound examinations. The results of fetal pathology after delivery or termination of pregnancy were used as the gold standard to judge the value of MRI prenatal screening in the diagnosis of fetal central nervous system and vertebral malformations. There was no significant difference between MRI and prenatal color Doppler ultrasound in the diagnosis of various types of fetal central nervous system developmental malformations (P>0.05), but the overall coincidence rate of diagnosis was higher than that of prenatal color Doppler ultrasound (P<0.05). The sensitivity of MRI for central nervous system malformations was 87.50%, the specificity was 86.36%, and the area under the curve(AUC)of ROC was 0.869. The sensitivity and specificity of color Doppler ultrasound in the diagnosis of fetal central nervous system malformations were 69.44% and 81.82%, and the AUC was 0.756. The coincidence rate of MRI in diagnosing scoliosis was higher than that of color Doppler ultrasound (P<0.05), the sensitivity and specificity of MRI in diagnosing fetal vertebral deformity were 86.36%, the specificity was 97.45%, and the AUC was 0.919. The sensitivity of color Doppler ultrasound was 50.00%, the specificity was 81.53%, and the AUC was 0.658. MRI technology had an obvious advantages over prenatal color Doppler ultrasound in diagnosing fetal central nervous system and vertebral malformation, and it could be worthy of clinical application.

Key words: magnetic resonance imaging, diagnosis, fetus, central nervous system, vertebral body, malformation