本文選題：磁共振 + 超聲��； 參考：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:在我國,每年大約有100萬先天缺陷或畸形的嬰兒出生,其中中樞系統(tǒng)類發(fā)育不全的嬰兒仍為首位,為家庭和社會帶來了沉重的負(fù)擔(dān)。因此,及早準(zhǔn)確診斷胎兒的中樞神經(jīng)系統(tǒng)疾病,有助于提高優(yōu)生優(yōu)育,對家庭和社會穩(wěn)定具有重要作用。產(chǎn)前超聲(ultrasound,US)檢查一直是胎兒產(chǎn)前首選的影像學(xué)檢查方法,但是超聲檢查在一定程度上也存在不足,需要其他檢查方法加以完善。MRI有著無射線損傷、良好的軟組織對比及空間分辨率、廣闊的視野等優(yōu)勢,完全具備成為超聲檢查之外的另一種重要的胎兒產(chǎn)前影像學(xué)檢查方法的條件。本研究擬通過分析比較MRI技術(shù)和超聲技術(shù)在檢測胎兒腦室擴(kuò)張方面的診斷一致性,探討MRI應(yīng)用于胎兒檢查的價值;同時,對影響胎兒磁共振圖像質(zhì)量因素作回歸分析,在實際操作中,避免可控的影響因素,提高胎兒磁共振圖像質(zhì)量,為準(zhǔn)確診斷胎兒中樞神經(jīng)系統(tǒng)疾病奠定基礎(chǔ)。方法:選取2014年3月至2015年11月在我院行胎兒超聲檢查并提示胎兒腦室擴(kuò)張并隨后進(jìn)行MRI檢查的120例孕婦作為研究對象,分析其超聲及磁共振技術(shù)檢測結(jié)果,實驗室染色體分析、孕婦血清學(xué)TORCH檢測、以及隨訪結(jié)果。探討影響胎兒磁共振圖像質(zhì)量因素作回歸分析研究以及比較超聲技術(shù)和MRI技術(shù)在檢測胎兒腦室擴(kuò)張方面的診斷價值。結(jié)果:第一部分經(jīng)過Logistic多因素回歸分析,我們統(tǒng)計得到心率(P0.001,Exp(B)=1.054)、胎動情況(P0.001,Exp(B)=20.04)、呼吸情況(P0.001,Exp(B)=4.07)、羊水量(P0.001,Exp(B)=1.05)對胎兒磁共振圖像質(zhì)量的影響有顯著意義,而孕周(P=0.54)對于磁共振圖像質(zhì)量無明顯統(tǒng)計學(xué)差異。因此,影響胎兒磁共振圖像質(zhì)量的因素包括:孕婦呼吸、心率、胎動、羊水量。在第二部分研究中,超聲診斷胎兒腦室擴(kuò)張的120例中,有92例胎兒超聲和MRI結(jié)果納入本研究中。磁共振符合超聲確診率為73.9%、MRI補(bǔ)充診斷率為26.1%。結(jié)論:本研究第一部分研究認(rèn)為在胎兒MRI檢查中,孕婦平穩(wěn)呼吸、心率正常、胎動不明顯等是保證圖像質(zhì)量的重要因素;第二部分表明MRI檢查可以作為超聲檢查胎兒腦室擴(kuò)張的重要補(bǔ)充手段,其在檢查診斷胎兒腦室擴(kuò)張合并其它中樞神經(jīng)系統(tǒng)疾病中的診斷價值明顯優(yōu)于超聲檢查。
[Abstract]:Objective: about 1 million babies with congenital defects or deformities are born every year in China. Therefore, early and accurate diagnosis of fetal central nervous system diseases is helpful to improve eugenics, and play an important role in family and social stability. Prenatal ultrasound ultrasound (USS) is always the first choice for prenatal imaging of fetus, but there are some deficiencies in ultrasound examination to a certain extent, and other examination methods need to be improved. MRI has no X-ray injury. The advantages of good soft tissue contrast, spatial resolution, wide field of vision and so on, fully possess the condition of becoming another important prenatal imaging method besides ultrasound examination. The purpose of this study was to analyze and compare the diagnostic consistency of MRI and ultrasound in the detection of fetal ventricular dilatation, to explore the value of MRI in fetal examination, and to make regression analysis on the factors affecting the quality of fetal magnetic resonance imaging. In practice, we can avoid controllable influencing factors, improve the quality of fetal magnetic resonance imaging, and lay a foundation for the accurate diagnosis of fetal central nervous system diseases. Methods: from March 2014 to November 2015, 120 pregnant women with fetal ventricular dilation and subsequent MRI examination were selected to analyze the results of ultrasound and magnetic resonance imaging (MRI), which were performed in our hospital from March 2014 to November 2015. Laboratory chromosome analysis, maternal serological TORCH test, and follow-up results. To study the factors influencing the quality of fetal magnetic resonance image and compare the diagnostic value of ultrasound and MRI in detecting fetal ventricular dilatation. Results: in the first part, by Logistic multivariate regression analysis, we found that the effects of heart rate, fetal movement, respiration, amniotic fluid volume and amniotic fluid volume on the quality of fetal magnetic resonance imaging were significant. However, there was no significant difference in the quality of magnetic resonance imaging (P < 0. 54). Therefore, factors affecting the quality of fetal magnetic resonance imaging include: maternal respiration, heart rate, fetal movement, amniotic fluid. In the second part of the study, 92 cases of fetal ventricular dilatation were diagnosed by ultrasound, 92 cases of fetal ultrasound and MRI results were included in this study. The diagnostic rate of MRI in accordance with ultrasonography was 73.9% and the rate of MRI supplementary diagnosis was 26.1%. Conclusion: in the first part of this study, it is considered that the smooth breathing, normal heart rate and unobvious fetal movement are the important factors to ensure the image quality in fetal MRI examination. The second part shows that MRI can be used as an important supplementary method for fetal ventricular dilatation, and its diagnostic value in diagnosing fetal ventricular dilatation with other central nervous system diseases is obviously superior to that of ultrasound.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R445.2;R714.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉海東;于紅;趙建國;許相豐;王南飛;王瑋;何曉燕;;MRI檢查在胎兒先天性腎臟異常診斷中的應(yīng)用[J];中華婦產(chǎn)科雜志;2016年12期

2 吳睿;;MRI在胎兒醫(yī)學(xué)中的應(yīng)用分析[J];人人健康;2016年12期

3 李志銘;陳焱淼;譚理連;張志興;黃勇;余林;楊慧;;磁共振彌散成像對妊娠中晚期羊水監(jiān)測的價值研究[J];中國醫(yī)學(xué)裝備;2016年06期

4 石慧;孫庚喜;李勝華;艾斌;劉鴻圣;曾斯慧;劉金武;全顯躍;;MR體素內(nèi)不相干運動成像對中晚孕期正常胎盤血流灌注的定量評價（英文）[J];中山大學(xué)學(xué)報(醫(yī)學(xué)科學(xué)版);2016年03期

5 張亞林;羅偉;周啟昌;廖榮信;周理超;;MRIB-FFE技術(shù)在胎兒腦室測量中的應(yīng)用[J];放射學(xué)實踐;2016年03期

6 朱銘;董素貞;;胎兒磁共振在產(chǎn)前診斷中的應(yīng)用及適應(yīng)證[J];中國實用婦科與產(chǎn)科雜志;2015年09期

7 葉錦棠;;3T磁共振成像在胎兒產(chǎn)前診斷中的應(yīng)用——機(jī)遇與挑戰(zhàn)[J];中國醫(yī)刊;2015年08期

8 苗志英;汪紅志;胡立偉;陳珊珊;施群雁;;基于MRI圖像的羊水體積的測量[J];中國醫(yī)學(xué)影像技術(shù);2015年04期

9 任泉霖;楊太珠;羅紅;李昌憲;楊帆;;超聲檢查和MRI在產(chǎn)前診斷胎兒Dandy-Walker變異型中的對比研究[J];中華婦幼臨床醫(yī)學(xué)雜志(電子版);2015年02期

10 張媛媛;趙青茹;孫麗洲;王小寧;;聯(lián)合產(chǎn)前影像學(xué)檢查在胎兒發(fā)育異常診斷中的應(yīng)用價值[J];南京醫(yī)科大學(xué)學(xué)報(自然科學(xué)版);2014年02期

相關(guān)會議論文 前2條

1 王音;徐鵬;龐s，

本文編號：1829546