>
网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
对比MRI与超声对唇腭裂的产前诊断价值:Meta分析
作者:王文轩1  母其文1  张利平2 3  李维1  张福洲1 
单位:1. 川北医学院第二临床医学院/南充市中心医院影像科, 四川 南充 637000;
2. 川北医学院第二临床医学院/南充市产前诊断中心, 四川 南充 637000;
3. 川北医学院第二临床医学院/南充市中心医院妇产科, 四川 南充 637000
关键词:胎儿 唇腭裂 产前诊断 磁共振成像 超声 Meta分析 
分类号:R782.204
出版年·卷·期(页码):2024·43·第一期(19-24)
摘要:

目的: 采用Meta分析比较磁共振成像(MRI)与超声(US)对唇腭裂产前诊断的临床应用价值。方法: 检索Embase、PubMed、Web of Science、Cochrane Library、万方、维普、中国知网及中国生物医学文献等数据库,查找比较MRI及US对胎儿唇腭裂产前诊断的相关研究,检索时限为2000年1月至2022年12月。计算汇总诊断比值比、灵敏度、特异度、阳性似然比、阴性似然比、受试者工作特性曲线下面积(AUC)、验前验后概率及95%CI。结果: 纳入文献6篇,共235例。MRI和US合并灵敏度分别为0.98(95%CI: 0.94~0.99)和0.70(95%CI: 0.35~0.91),差异有统计学意义(P<0.05)。MRI和US合并特异度分别为0.84(95%CI: 0.76~0.90)和0.59(95%CI: 0.21~0.89),差异有统计学意义(P<0.05)。MRI的AUC显著高于US的AUC(0.98vs.0.84,P<0.05)。结论: 对于胎儿唇腭裂的产前诊断,MRI较US诊断效能更高,可作为产前US诊断的首要补充方法。

Objective: To use Meta-analysis to compare magnetic resonance imaging(MRI) with ultrasound(ultrasound,US) for prenatal diagnosis of fetal cleft lip and palate. Methods: Embase,PubMed,Web of Science,Cochrane Library,Wanfang,Weipu,CNKI and Chinese Biomedical Literature were searched to find all relevant studies comparing MRI and US for prenatal diagnosis of cleft lip and palate in fetuses,and the search period was from January 2000 to December 2022,meanwhile,the references of the included articles were reviewed. Inclusion and exclusion criteria were developed,and Stata 17.0 was used for Meta-analysis. Pooled diagnostic odds ratio(DOR),sensitivity(SEN),specificity(SPE),positive likelihood ratio(+LR),negative likelihood ratio(-LR),area under the receiver operating characteristic curve(AUC),a priori posterior probability and 95%CI were calculated. Calculation of the Z statistic. Results: Six articles with 235 cases were included. MRI combined sensitivity vs. US combined sensitivity was[0.98(95%CI:0.94-0.99) vs. 0.70(95%CI:0.35-0.91),P<0.05]. MRI combined specificity vs. US combined specificity was[0.84(95%CI:0.76-0.90) vs. 0.59(95%CI:0.21-0.89),P<0.05]. The AUC of MRI was significantly higher than that of US(0.98 vs. 0.84,P<0.05).Conclusion: For prenatal diagnosis of cleft lip and palate in fetuses,MRI has higher diagnostic efficacy than US. Us is the method of choice for fetal cleft lip and palate screening,and MRI examination can be used as the first complementary method for the diagnosis when the diagnosis of cleft palate is unfavorable or cannot be made definitively.

参考文献:

[1] FAN D,WU S,LIU L,et al.Prevalence of non-syndromic orofacial clefts:based on 15,094,978 Chinese perinatal infants[J].Oncotarget,2018,9(17):13981-13990.
[2] MOSSEY P A,LITTLE J,MUNGER R G,et al.Cleft lip and palate[J].Lancet,2009,374(9703):1773-1785.
[3] 谢理哲,陈雅丽,高鹏程,等.三维照相系统采集单侧唇腭裂患者面部形态的精确性研究[J].东南大学学报(医学版),2017,36(6):995-1001.
[4] 黄晓莉,孙丽洲.18 755例孕妇无创DNA检测的产前诊断结果分析[J].现代医学,2022,50(8):1015-1021.
[5] 李载红,洪燕,覃伶伶,等.海口地区正常单胎胎儿妊娠早期NT厚度参考值的建立[J].东南大学学报(医学版),2016,35(2):202-204.
[6] 王光彬,陈立光,朱向玉,等.胎儿唇腭裂的MRI表现[J].中华放射学杂志,2010,44(2):152-155.
[7] WANG G B,SHAN R Q,MA Y X,et al.Fetal central nervous system anomalies:comparison of magnetic resonance imaging and ultrasonography for diagnosis[J].Chin Med J(Engl),2006,119(15):1272-1277.
[8] JADAD A R,MOORE R A,CARROLL D,et al.Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J].Control Clin Trials,1996,17(1):1-12.
[9] ATHANASIOU T,AL-RUZZEH S,KUMAR P,et al.Off-pump myocardial revascularization is associated with less incidence of stroke in elderly patients[J].Ann Thorac Surg,2004,77(2):745-753.
[10] 张理玲,李亚敏,王丽华.MRI及四维超声在产前胎儿唇腭裂畸形诊断中的价值[J].中国CT和MRI杂志,2020,18(12):35-37,189.
[11] 曾益辉,董冲,李晖,等.MRI在产前诊断胎儿唇腭裂畸形中的应用价值[J].放射学实践,2022,37(1):99-103.
[12] 田迷迷,肖连祥,渐楠,等.超声和MRI对胎儿唇腭裂的诊断价值[J].山东大学学报(医学版),2018,56(12):62-67.
[13] 邓志贤,郭晓燕,谭卫荷,等.磁共振成像与超声成像诊断胎儿唇腭裂的临床分析[J].中国医药科学,2019,9(17):139-141.
[14] DABADIE A,QUARELLO E,DEGARDIN N,et al.Added value of MRI for the prenatal diagnosis of isolated orofacial clefts and comparison with ultrasound[J].Diagn Interv Imaging,2016,97(9):915-921.
[15] MAILÁTH-POKORNY M,WORDA C,KRAMPL-BETTELHEIM E,et al.What does magnetic resonance imaging add to the prenatal ultrasound diagnosis of facial clefts?[J].Ultrasound Obstet Gynecol,2010,36(4):445-451.
[16] 何倩云,杨苑香,陈敏,等.产前诊断唇腭裂308例回顾性研究[J].实用妇产科杂志,2017,33(9):688-691.
[17] 席梅,刘卫星,曾莉,等.二维及三维超声在胎儿唇腭裂产前诊断中的应用[J].中华医学超声杂志(电子版),2013,10(4):281-285.
[18] SMARIUS B,LOOZEN C,MANTEN W,et al.Accurate diagnosis of prenatal cleft lip/palate by understanding the embryology[J].World J Methodol,2017,7(3):93-100.
[19] GRANDJEAN H,LARROQUE D,LEVI S.The performance of routine ultrasonographic screening of pregnancies in the Eurofetus study[J].Am J Obstet Gynecol,1999,181(2):446-454.
[20] WANG G,SHAN R,ZHAO L,et al.Fetal cleft lip with and without cleft palate:comparison between MR imaging and US for prenatal diagnosis[J].Eur J Radiol,2011,79(3):437-442.
[21] VAN DER HOEK-SNIEDERS H E M,VAN DEN HEUVEL A J M L,VAN OS-MEDENDORP H,et al.Diagnostic accuracy of fetal MRI to detect cleft palate:a meta-analysis[J].Eur J Pediatr,2020,179(1):29-38.
[22] LAI G P,WENG X J,WANG M,et al.Diagnostic accuracy of prenatal fetal ultrasound to detect cleft palate in high-risk fetuses:a systematic review and meta-analysis[J].J Ultrasound Med,2022,41(3):605-614.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 428253 位访问者


copyright ©《东南大学学报(医学版)》编辑部
联系电话:025-83272481 83272483
电子邮件:
bjb@pub.seu.edu.cn

苏ICP备09058364