小波阈值降噪的超声多普勒技术在胎儿中枢神经系统畸形筛查中的临床应用价值

摘要 目的：探究小波阈值降噪的超声多普勒技术在胎儿中枢神经系统（CNS）畸形筛查中的临床应用价值。方法：选择2018年1月-2021年1月于本院进行规范化妊娠早期超声结构筛查的1092例11-13+6周单胎妊娠孕妇，所有孕妇均进行常规超声和小波阈值降噪的超声多普勒技术的检查，并对其妊娠过程和结果进行随访。结果：1092例胎儿产后病理或超声检查显示，胎儿CNS畸形共计19例，发生率为1.74％（19/1092）。其中，露脑畸形8例，无脑畸形5例，前脑无裂畸形3例，脑膜膨出2例，脊柱裂1例。基于小波阈值降噪的超声多普勒技术对胎儿CNS畸形检出的符合率94.74%（18/19）显著高于常规超声63.16%（12/19），差异有统计学意义（P<0.05）；且基于小波阈值降噪的超声多普勒技术检出胎儿CNS畸形的准确性、敏感度、特异度、阳性预测值、阴性预测值均显著高于常规超声，差异均均有统计学意义（P<0.05）。结论：小波阈值降噪的超声多普勒技术对妊娠早期孕妇进行规范化结构筛查更有助于及早发现胎儿CNS畸形，对降低畸形胎儿的出生率以及指导临床治疗方案的选择具有重要指导意义。

Clinical Value of Ultrasonic Doppler Technology Based on Wavelet Threshold Denoising in Fetal Central Nervous System Malformation Screening

ABSTRACT Objective: To explore the clinical value of ultrasonic doppler technology based on wavelet threshold denoising in fetal central nervous system(CNS) malformation screening. Methods: 1092 pregnant women with singleton pregnancy of 11-13+6 weeks who underwent standardized early pregnancy ultrasound structure screening in our hospital from January 2018 to January 2021 were selected. All pregnant women were examined by conventional ultrasound and wavelet threshold denoising ultrasound doppler technology, and their pregnancy process and results were followed up. Results: The postpartum pathology or ultrasonography of 1092 fetuses showed that there were 19 cases of fetal CNS malformation, and the incidence was 1.74% (19/1092). Among them, there were 8 cases of exposed brain malformation, 5 cases of anencephaly, 3 cases of holoprosencephaly, 2 cases of meningocele and 1 case of spina bifida. The coincidence rate of ultrasonic doppler technology based on wavelet threshold denoising in the detection of fetal CNS malformations was 94.74%(18/19), which was significantly higher than that of conventional ultrasound 63.16%(12/19), the difference was statistically significant(P<0.05); The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of ultrasonic doppler technology based on wavelet threshold denoising were significantly higher than those of conventional ultrasound, the difference was all statistically significant(P<0.05). Conclusion: The standardized structure screening of pregnant women in early pregnancy by wavelet threshold denoising ultrasonic doppler technology is more conducive to the early detection of fetal CNS malformations, which is of great guiding significance to reduce the birth rate of abnormal fetuses and guide the selection of clinical treatment schemes.