【摘要】 目的探讨超声检查应用于胎儿尿道下裂诊断中的价值。方法回顾性分析2011年1月～2017年12月绵阳市中心医院和南充市中心医院产科31例孕妇的病历资料,产前均因疑诊胎儿尿道下裂而序贯予以2DUS和辅以3DUS检查,总结胎儿尿道下裂的超声图像特征及漏误诊情况,比较不同声像图特征的出现几率及对尿道下裂的正确诊断率。以分娩(或引产)后的结果为诊断的金标准,对两种检查方法诊断尿道下裂的敏感性、特异性及准确性进行比较分析。结果共计31例患者,经生产(或引产)后确诊为非尿道下裂6例,尿道下裂25例。"阴茎短小"的出现率高,但特异性差;而"喷尿异常"与"尿道连续性中断"出现率低,但特异性高。31例疑诊病例,经2DUS准确诊断22例,漏诊5例,误诊4例,其诊断的敏感性、特异性、准确性分别为80.0%、33.33%、70.97%;而2DUS辅以3DUS准确诊断27例,漏诊3例,误诊1例,诊断的敏感性、特异性、准确性分别为88.00%、83.33%、87.10%。两种成像方法比较,差异有统计学意义(P<0.05)。结论超声检查是诊断尿道下裂的可靠手段,2DUS辅以3DUS应用于尿道下裂的产前诊断,相较于单用2DUS,能明显提高诊断的敏感性、特异性及准确性,具有重要临床应用价值。更多还原

【Abstract】 Objective To explore the value of ultrasonography in the diagnosis of fetal hypospadias.Methods From January 2011 to December 2017, 31 cases of pregnant women in the obstetrics department of Mianyang Central Hospital and Nanchong Central Hospital were analyzed retrospectively. 2 DUS and 3 DUS examinations were performed in sequence due to suspected hypospadias. The ultrasonic image features and missed and misdiagnosed cases of hypospadias were summarized. The occurrence rate of different sonographic features and the correct diagnosis rate of hypospadias were compared. Based on the results of labor(or induction) as the gold standard of diagnosis, the sensitivity, specificity and accuracy of the two methods were compared.Results A total of 31 cases were diagnosed as non hypospadias in 6 cases and hypospadias in 25 cases. The occurrence rate of "penile shortness" was high, but the specificity wass poor; while the occurrence rate of "abnormal urine spraying" and "interruption of urethral continuity" was low, but the specificity was high. Among 31 suspected cases, 22 cases were accurately diagnosed by 2 DUS, 5 cases were missed and 4 cases were misdiagnosed. The sensitivity, specificity and accuracy of the diagnosis were 80.0%, 33.33% and 70.97% respectively, while 27 cases were accurately diagnosed by 2 DUS with 3 DUS, 3 cases were missed and 1 case was misdiagnosed. The sensitivity, specificity and accuracy of the diagnosis were 88.00%, 83.33% and 87.10% respectively. The difference between the two imaging methods was statistically significant(P < 0.05).Conclusion Ultrasonography is a reliable method for diagnosis of hypospadias. The application of 2 DUS combined with 3 DUS in prenatal diagnosis of hypospadias can significantly improve the sensitivity, specificity and accuracy of diagnosis compared with 2 DUS alone.更多还原