目的 探讨四维彩超在胎儿先天性畸形中的诊断价值.方法 随机观察我院2012年1月至2014年1月孕中晚期孕妇1200例产前常规超声检查结果,所有孕妇均进行了二维超声和四维超声检查,并随访至产后1个月,比较二维超声和四维超声诊断胎儿先天性畸形的准确性.结果 经产后临床证实,共发现先天性胎儿畸形34例,其中神经管畸形10例,心脏畸形8例,唇腭裂7例,泌尿系畸形3例,四肢畸形3例,腹部畸形1例,其他2例.四维超声检出畸形31例,与产后符合率91.17％;漏诊3例,其中多指畸形1例,脊柱裂2例.二维超声检出畸形26例,符合率76.47％;漏诊8例,其中唇腭裂2例,多指畸形2例,脊柱裂3例,足内翻1例.二维和四维超声的诊断符合率比较差异具有统计学意义(P＜0.05).结论 四维超声更能多方位、多切面观察胎儿宫内发育情况,对诊断胎儿体表畸形具有更直观和准确的判断,具有较高的临床价值.%Objective To investigate the diagnostic value of four-dimensional (4D) color Doppler ultrasound examination in prenatal screening of fetal malformation.Methods 1200 pregnant women were observed and detected by four-dimensional color Doppler and two dimensional ultrasound.The results were compared with the results confirmed by clinical pathology.Results 34 cases were detected with congenital defects; among which,10 got defects in nervous system,8 heart deformity,7 cheilopalatognathus,3 urinary tract malformation,3 limb deformity,1 abdominal deformity,and the other 2 cases.31 cases were detected with deformity by four-dimensional color Doppler,with a postpartum coincidence rate of 91.17％; and 3 cases were misdiagnosed,of which 1 case had polydactyly deformity and 2 cases spina bifida.26 cases were detected with deformity by two-dimensional ultrasony,with a postpartum coincidence rate of 76.47％; and 8 cases were misdiagnosed,of which 2 cases had cleft lip and palate,2 case polydactyly deformity,3 cases spina bifida,and 1 cases strephenopodia.There were statistical differences between the two methods (P ＜ 0.05).Conclusions Four-dimensional color Doppler can multi-dimensionally and multi-sectionly observe the abnormal development of fetus and has high clinical value for surface deformity fetus and a more intuitive and accurate judgment.
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