影像科学与光化学2024，Vol.42Issue(4)：318-326,9.DOI:10.7517/issn.1674-0475.2024.04.04
产前多超声参数评估胎儿生长受限的价值及诊断假阴性影响因素分析
The Value of Prenatal Multi-ultrasound Parameters in the Evaluation of Fetal Growth Restriction and the Analysis of the Influencing Factors of False Negative Diagnosis
摘要
Abstract
Objective:To explore the value of prenatal color Doppler ultrasound in the evaluation of fetal growth restriction(FGR)and analyze the influencing factors of false negative ultrasound diagnosis.Methods:From October 2019 to July 2023,118 fetuses diagnosed as FGR by prenatal color Doppler ultrasound and confirmed by postpartum follow-up were selected as the true positive group of FGR,and 60 fetuses with negative FGR diagnosed by prenatal color Doppler ultrasound and postpartum FGR were selected as the false negative group of FGR.The ultrasonic parameters of different gestational weeks between the two groups were compared at the first examination.The clinical data of the two groups of fetuses were compared,and the factors affecting the false negative of FGR diagnosed by ultrasound were screened by random forest algorithm and multivariate Logistic regression analysis.Multi-factor Logistic regression model was constructed and its prediction efficiency was evaluated.Results:At the 12th and 14th week of pregnancy,the abdominal circumference and femoral length of the false negative group were significantly longer than those of the true positive group,and the end systolic peak(S)/end diastolic peak(D)of blood flow in the false negative group was significantly lower than that in the true positive group(P＜0.05).At 15-27 weeks of pregnancy,the abdominal circumference and femoral length of the fetus in the false negative group were significantly longer than those in the true positive group(P＜0.05).At 28-37 weeks of pregnancy,the abdominal circumference of the fetus in the false negative group was significantly longer than that in the true positive group(P＜0.05).The results of random forest algorithm and multivariate Logistic regression analysis showed that higher weight gain during pregnancy,gestational diabetes mellitus,breech position,gestational age＞40 weeks,male fetus and increased abdominal circumference were the risk factors for false negative FGR diagnosis by ultrasound(P＜0.05).When the probability of false negative diagnosis of FGR by model prediction ultrasound is 0.85,the Yoden index is the highest(74.46),the sensitivity is 86.45％,and the specificity is 88.01％.the logical regression goodness-of-fit test results show that Nagelkerke R2 is 0.602 before and after Bootstrap verification of the model.Conclusion:With the increase of gestational weeks(12-37 weeks),the number of differences between true-positive and false-negative fetuses diagnosed by ultrasound for the first time decreased gradually.Weight gain during pregnancy,gestational diabetes and fetal position were the risk factors affecting false-negative diagnosis of FGR by ultrasound.关键词
胎儿生长受限/彩色多普勒超声/产前诊断/假阴性/影响因素Key words
fetal growth restriction/color Doppler ultrasound/prenatal diagnosis/false negative/influencing factors分类
医药卫生引用本文复制引用
郭媛,陈小梅,候燕,马淑琴..产前多超声参数评估胎儿生长受限的价值及诊断假阴性影响因素分析[J].影像科学与光化学,2024,42(4):318-326,9.基金项目
宁夏自然科学基金项目(2020AAC03383) （2020AAC03383）
