摘要探讨超声检查对妊娠初期胎儿中枢神经系统( Central nervous system,CNS)畸形的诊断价值.方法 选取2017年1月至2018年1月在温州市中西医结合医院经超声检查诊断的妊娠初期CNS畸形胎儿190例进行研究,对超声检查妊娠初期胎儿CNS畸形的诊断价值进行分析.结果 在190例妊娠初期胎儿中有184例得到了满意的头胸部正中矢状切面、侧脑室的水平横切面,脊柱的长轴切面,小脑及后颅窝池的切面,在这184例中得到的1l～11 +6周显示率为93.33%,得到的12～12 +6周显示率为97.20%,得到的13～13 +6周显示率为97.06%.对不同孕周的CNS超声检查的显示率进行比较,差异无统计学意义( χ2 ＝0.981,P＞0.05).妊娠初期诊断CNS畸形胎儿6例中有3例同时合并其他畸形其中1例考虑Cantrell五联症伴CNS畸形,1例左侧膈疝、右移心,1例正中唇腭裂、单心房室伴肺动脉闭锁、双侧桡骨缺失;此外有4例胎儿的胎儿颈项透明层值大于3 mm.妊娠初期诊断胎儿CNS畸形的特异度为100.00%,敏感度为85.71%,特异度为100.00%,阳性预测值为99.46%.结论 采用超声检查进行妊娠初期胎儿CNS畸形的诊断,可以提高确诊率,具有较高的临床应用价值.

abstractsObjective To explore the diagnostic value of ultrasound imaging for fetal central nervous system (CNS) malformation in early pregnancy.Methods From January 2017 to January 2018,a total of 190 cases of CNS malformation in early pregnancy , who were diagnosed by ultrasound imaging in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine were selected to analyze the clinical value of ultrasound imaging in the diagnosis of fetal CNS malformation in early pregnancy.Results Of the 190 pregnancies,184 patients had satisfactory median sagittal section of the head and chest ,horizontal cross section of the lateral ventricle ,long axis of the spine, and cerebellum and posterior fossa pool.In 184 cases,the probability of display from 1 to 11 +6 weeks was 93.33%, the probability of display from 12 to 12 +6 weeks was 97.20%,and the probability of display from 13 to 13 +6 weeks was 97.06%.Compared the display rates of CNS ultrasound examinations at different gestational weeks ,the difference was not statistically significant (χ2 ＝0.981,P＞0.05).Three cases of 6 cases of CNS malformation diagnosed in early pregnancy were combined with other malformations.One case considered Cantrell＇s hypothyroidism with CNS malformation,1 case with left iliac crest and right circumflex , 1 case with median cleft lip and palate , single atrioventricular with pulmonary atresia.The bilateral humerus was missing ,in addition,4 fetuses had an NT value more than 3 mm.The specificity of diagnosis of fetal CNS malformation in early pregnancy was 100.00%,the sensitivity was 85.71%,the specificity was 100.00%, and the positive predictive value was 99.46%.Conclusion Ultrasound imaging in the diagnosis of fetal CNS malformation in early pregnancy can improve the diagnosis rate and has high clinical value.