目的 探讨早中孕期颅脑冠状切面鼻尖偏斜法在筛查胎儿颜面部畸形中的临床价值.方法 采用颅脑冠状切面鼻尖偏斜法超声检查,对5000例早中孕期孕妇的胎儿进行颜面部结构检查.根据进行超声检查的时间,分为11～12+6周组、13～14+6周组、15～16+6周组.分析胎儿颜面部结构显示情况以及胎儿畸形检出率.结果 所有孕妇超声检查均可以清楚显示颅脑冠状切面,其中4855例(97.10％)可见较为理想的小脑横切面、双眼球水平冠状切面、鼻后三角切面等.三组胎儿超声检查显示率没有统计学差异.有69例(1.38％)出现颜面部畸形,其中31例(44.93％)为单纯颜面部畸形,38例(55.07％)合并其他结构畸形.该方法的敏感度、特异性、阳性预测值、阴性预测值分别为93.24％,100％,100％,99.90％.结论 颅脑冠状切面鼻尖偏斜法对胎儿颜面部畸形的检出率和灵敏度较高是中早孕期胎儿颜面部排畸检查的可靠方法.%Objective To analyze the value of cerebral coronary view of nose tip deflection in screening fetal facial deformity in the first and second trimester. Methods All cases were divided into the 11～12+6 weeks, the 13 ～ 14+6 weeks and the 15 ～ 16+6 weeks undergone ultrasonographic examination on coronal view of nose tip deflection. The display of fetal facial structure and the detection rate of fetal facial malformation were analyzed. Results The fetal facial anatomic structures were clearly displayed. The median sagittal section ,eyes level coronal section ,retronasal triangle section ,or other sections were satisfactory in 4855 cases (97.10％). There was no Statistical difference in the display of fetal facial structures among the three groups. 69 fetus were found with facial malformations,including 31 fetus with facial malformations only,and 38 fetus combined with other abnormal struc-tures. The sensitivity,specificity,positive predictive value and negative predictive value were 93.24％,100％, 100％ and 99.90％ respectively. Conclusion The cerebral coronary view of nose tip deflection method has high detection rate and sensitivity,and is a reliable method for detecting fetal facial abnormalities in the first and second trimester.
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