B超和MRI在胎儿骨骼异常中的诊断价值分析

doi:10.11938/cjmr20253143

摘要/Abstract

摘要：

磁共振成像（Magnetic Resonance Imaging，MRI）在孕中期胎儿骨骼异常诊断领域具有重要研究价值.当前，该诊断面临精准度及影响妊娠结局评估方面的挑战，传统产前B超在诊断效能等方面存在一定局限．本文在2021年1月至2024年1月期间，对58例经引产或分娩后证实为胎儿骨骼异常的孕妇的孕中期影像报告进行研究发现，MRI相较于B超，胎儿骨骼异常检出例数、引产建议的诊断符合率、影像质量总优良率更高．MRI在孕中期胎儿骨骼异常诊断中价值显著，能为孕妇及家属提供可靠胎儿骨骼信息，利于改善妊娠结局，保障优生优育，临床应用前景广阔．

关键词: 磁共振成像, 孕中期胎儿, 骨骼畸形, 妊娠结局, 诊断价值

Abstract:

Magnetic resonance imaging (MRI) demonstrates significant value in the diagnosis of fetal skeletal abnormalities during the second trimester. Current clinical practice confronts challenges in improving diagnostic accuracy and assessing the impact of diagnosis on pregnancy outcomes, while conventional prenatal B-scan ultrasonography has limitations in diagnostic efficacy. From January 2021 to January 2024, this study analyzed the second-trimester imaging reports of 58 cases who were confirmed with fetal skeletal abnormalities after labor induction or delivery, revealing MRI's superior diagnostic performance compared to B-scan ultrasonography in the detection rate of fetal skeletal abnormalities, the diagnostic coincidence rate of induced abortion recommendations and overall excellent image quality rate. The diagnostic value of MRI for detecting fetal skeletal abnormalities in the second trimester makes it a reliable technique to provide fetal skeletal information for pregnant women and their families, which is conducive to pregnancy outcomes and healthy birth, and has broad clinical application prospects.

Key words: magnetic resonance imaging, second trimester fetus, skeletal malformations, pregnancy outcome, diagnostic value

中图分类号:

O482.53

舒炜. B超和MRI在胎儿骨骼异常中的诊断价值分析[J]. 波谱学杂志, 2025, 42(3): 265-274.

SHU Wei. Diagnostic Efficacy Comparison of B-scan Ultrasonography and MRI in Fetal Skeletal Abnormalities[J]. Chinese Journal of Magnetic Resonance, 2025, 42(3): 265-274.

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检查方式	AUC	灵敏度	特异性	约登指数	标准误	P值	95%CI
B超检查	0.792	81.65%	77.83%	0.595	0.12	<0.001	0.705~0.808
MRI检查	0.902	90.17%	88.53%	0.787	0.15	<0.001	0.839~0.943
联合检查	0.925	90.39%	89.04%	0.794	0.10	<0.001	0.894~0.944

检查方式	优	良	差	优良
B超检查	48（82.76）	2（3.45）	8（13.79）	50（86.21）
MRI检查	52（89.66）	4（6.89）	2（3.45）	56（96.55）
χ²				3.940
P				0.047

骨骼畸形种类	实际发生例数	B超检出例数	MRI检出例数
足内翻	13（22.41）	10（17.24）	13（22.41）
多（并）指、趾	9（15.52）	7（12.07）	9（15.52）
手缺失	9（15.52）	8（13.79）	9（15.52）
桡骨缺失	6（10.34）	5（8.62）	6（10.34）
颅骨缺失	5（8.62）	5（8.62）	5（8.62）
股骨不等长	3（5.19）	2（3.45）	2（3.45）
尾端退化综合征	2（3.45）	1（1.73）	1（1.72）
脊柱裂	7（12.06）	5（8.62）	6（10.34）
骨不全	4（6.89）	3（5.17）	4（6.89）
总计	58（100.00）	46（79.31）	55（94.84）