超声与磁共振成像在胎儿消化道畸形诊断中效能比较及影像学特征分析OA

Objective:To explore the correlation of imaging characteristics,and the diagnostic value of ultrasound(US)scanner and magnetic resonance imaging(MRI)in diagnosing gastrointestinal malformations of fetus.Methods:A total of 100 pregnant women with suspected gastrointestinal malformations of fetus,who admitted to Tangshan Maternal and Children Health Hospital between January 2018 and December 2023,were enrolled.Based on postnatal surgical pathology results,they were categorized into a malformation group(n=30)and a non-malformation group(n=70).All pregnant women underwent both US and MRI examinations.The indicators from the two kinds of imaging techniques were compared,and the results of surgical pathology were used as golden standard,and the receiver operating characteristic(ROC)curve was drawn to assess the diagnostic efficiency.Results:In US examination,the positive rates of absent stomach bubble,hyperechogenic bowel,bowel dilatation,polyhydramnios,and an abnormal ratio of abdominal circumference to head circumference in malformation group were significantly higher than those in non-malformation group(x2=12.658,24.137,32.143,24.892,16.235,P<0.05).In MRI examination,the positive rates of absent signal of gastric bubble,bowel dilatation,mal-rotation of the intestines,and spinal abnormalities in malformation group were also significantly higher than those in non-malformation group,and the differences were significant(x2=14.286,36.923,20.690,5.769,P<0.05).The diagnostic sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of MRI examination were superior to those of US examination.There was significant difference in area under curve(AUC)value of receiver operating characteristic(ROC)curve between two kinds of techniques(Z=2.134,P=0.033).The Kappa coefficient of consistency between US and surgical pathology was 0.723,and it was 0.817 between MRI and surgical pathology.In addition,it was 0.685 in consistency between US and MRI.Multivariate analysis identified bowel dilatation,polyhydramnios,and absent stomach bubble were independent predictors of gastrointestinal malformations of fetus(OR=8.463,5.831,1.190,P<0.05).Conclusion:MRI provides higher diagnostic efficiency and stronger consistency than US in diagnosing gastrointestinal malformations of fetus.For gastrointestinal malformations of fetus,which were diagnosed by US examination,the MRI examination can further provide higher diagnostic efficiency and consistency with pathological results.