摘要目的:比较四维彩超和系统B超在筛查胎儿先天性畸形中的应用价值。方法:选取2017年6月至2018年12月于山西省人民医院进行胎儿先天性畸形检查的94例孕妇为研究对象，对其检查结果进行回顾性分析，其中接受四维彩超检查的47例孕妇作为四维彩超组，接受系统B超检查的47例孕妇作为系统B超组。以孕妇引产或分娩后人工观测、X线检查等方式确诊的胎儿畸形情况为金标准，将两组检查结果与金标准进行对比，分析两种检查方法对胎儿先天性畸形筛查的灵敏度和特异度。结果:两组胎儿畸形情况的金标准检查结果比较差异未见统计学意义( P>0.05)。四维彩超检查与金标准结果比较，漏诊胎儿躯干畸形1例(2.13%)，系统B超检查与金标准结果比较，遗漏诊断头面部畸形2例(4.26%)、心脏畸形1例(2.13%)、躯干畸形1例(2.13%)。两种检查方法均无将胎儿畸形部位错诊的情况，灵敏度均为100.00%，而四维彩超检查的灵敏度(93.75%)高于系统B超检查的灵敏度(69.23%)。 结论:四维彩超对胎儿先天性畸形的筛查诊断价值比系统B超要高。

abstractsObjective:To compare the application value of four-dimensional color ultrasound and system B-mode ultrasound in screening fetal congenital malformation.Methods:A total of 94 pregnant women who underwent congenital malformation examination in Shanxi Provincial People’s Hospital from June 2017 to December 2018 were selected as the research subjects. Their examination results were analyzed retrospectively. Among them, 47 pregnant women who underwent four-dimensional color Doppler ultrasound were regarded as four-dimensional ultrasound group, and 47 pregnant women who received system B-mode ultrasound examination were regarded as system B-mode ultrasound group. The fetal malformations diagnosed by visual check after maternal induction or labour and X-ray examination, were used as the gold standard. The results of the two groups were compared with the gold standards, to analyze the sensitivity and specificity of two methods in screening fetal congenital malformation.Results:There was no significant difference in the gold standard examination results of fetal malformation between the two groups ( P>0.05). Compared with the gold standard, the results of four-dimensional color Doppler ultrasound missed 1 case (2.13%) of fetal trunk deformity; compared with the gold standard, the system B-mode ultrasound diagnosis missed 2 cases (4.26%) of head and face malformations, 1 case (2.13%) of cardiac malformations, and 1 case (2.13%) of trunk deformities. Both methods did not misdiagnose the abnormal part of the fetus, and the sensitivity was 100.00%. The sensitivity of the four-dimensional color Doppler ultrasound examination was 93.75%, which was higher than the 69.23% of the system B-ultrasound examination. Conclusions:The diagnostic value of four-dimensional color Doppler ultrasound for fetal congenital malformation is higher than that of system B-mode ultrasound.