摘要
目的:探索1.5T磁共振成像(MRI)与三维超声对胎儿小脑蚓部发育异常的评价及其与胎龄的关系。方法:选取医院收治的146例产前检查示胎儿疑似小脑蚓部发育异常的孕产妇,均行1.5TMRI和三维超声检查后,采用受试者工作特征(ROC)曲线分析三维超声、1.5TMRI预测效能,并比较两者的蚓部前后径(AP)、脑干小脑蚓部角(BV)、小脑半球高度(CH)、脑干小脑幕角(BT)、蚓部上下径(CC)、小脑半球宽度(CW)差异以及不同孕周下相关脑数据,分析不同孕周与各项脑数据相关性。结果:146例孕产妇经引产或分娩结果显示,正常胎儿25例、异常胎儿121例。MRI诊断准确率85.12%(103/121),三维超声诊断准确率76.86%(93/121),两项联合诊断准确率97.52%(118/121)。经ROC曲线分析,三维超声、MRI以及两项联合诊断小脑蚓部发育异常的ROC曲线下面积(AUC)分别为0.744、0.826和0.968。异常胎儿通过MRI检查和三维超声检查BV差异有统计学意义(t=8.257,P<0.05),其他差异均无统计学意义。而比较正常胎儿和异常胎儿各项脑相关数据,三维超声检查下,CW、CH及BT差异有统计学意义(t=4.609,t=7.377,t=3.157;P<0.05);MRI检查下,CW、CH、BT及BV差异有统计学意义(t=3.780,t=5.206,t=3.352,t=4.211;P<0.05)。经Spearman法分析,孕周与AP、CC、CW、CH、BT及BV呈正相关性(r=0.995,r=0.996,r=0.981,r=0.949,r=0.985,r=0.985;P<0.05)。结论:三维超声、MRI均可有效评估胎儿小脑蚓部发育情况,联合诊断可提高诊断准确率。同时AP、CC、CW、CH、BT及BV数据与胎龄存在密切相关性,通过影像技术测量脑相关数据,对小脑异常发育具有一定评估作用。
Objective:To explore the evaluation of 1.5T magnetic resonance imaging(MRI) and three-dimensional(3D) ultrasound on abnormal development of fetal cerebellar vermis and the relationship of that with gestational week.Methods:146 pregnant and lying-in women,whose fetuses were suspected with abnormal development of fetal cerebellar vermis,were selected.And all of them underwent 1.5T MRI and 3D ultrasound examination.The receiver operating characteristics(ROC) curve was adopted to analyze the predictive efficiencies of 3D ultrasound and 1.5T MRI.The differences of anteroposterior diameter(AP) of vermis,brainstem-vermis(BV) angle of brainstem,cerebellar hemisphere(CH),brainstem-tentorium(BT) angle,craniocaudal(CC) diameter of vermis and cerebellar width(CW)of hemisphere,as well as the relative brain data under different gestational weeks,were compared between two methods.And the correlation between different gestational weeks and each brain data were further analyzed.Results:The results of induced labor or delivery of 146 pregnant and lying –in women indicated that 25 cases were normal fetuses and 121 cases were abnormal fetuses.The diagnostic accuracies of MRI,3D ultrasound and the combined diagnosis of them were 85.12%(103/121),76.86%(93/121) and 97.52%(118/121),respectively.The results of ROC curve analysis indicated that the area under curves(AUCs) of 3D ultrasound,MRI and the combination of them were 0.744,0.826 and 0.968 in diagnosing abnormal development of the cerebellar vermis,respectively.The difference of BV of abnormal fetuses between MRI examination and 3D ultrasound examination was significant(t=8.257,P<0.05),while the differences of others were not statistically significant.The comparisons of each relevant data of brain between normal and abnormal fetuses indicated that the differences of CW,CH and BT under 3D ultrasound between them were significant(t=4.609,t=7.377,t=3.157,P<0.05),and the differences of CW,CH,BT and BV under MRI between them were significant(t=3.780,t=5.206,t=3.352,t=4.211,P<0.05).The
作者
张毓瑾
李学胜
雷显高
贾凤林
张波
李开明
ZHANG Yu-jin;LI Xue-sheng;LEI Xian-gao(Radiology Department,West China Second University Hospital,Sichuan University,Chengdu 610041,China;不详)
出处
《中国医学装备》
2022年第8期62-67,共6页
China Medical Equipment
基金
国家重点研发计划生殖健康及重大出生缺陷防控研究重点专项(2018YFC1002200)“MRI评价胎儿小脑蚓部发育及其与胎龄的关系”。
关键词
磁共振成像(MRI)
三维超声
小脑蚓部发育异常
胎龄
Magnetic resonance imaging(MRI)
Three-dimensional(3D)ultrasound
Abnormal development of cerebellar vermis
Gestational week
