Z-Score of Fetal Cardiothoracic Ratio in Prediction of Homozygous α-Thalassemia in Early Pregnancy
10.3969/j.issn.1005-5185.2025.09.016
- VernacularTitle:胎儿心胸比Z-评分在早孕期预测重型α-地中海贫血的应用
- Author:
Xinyi ZHOU
1
;
Xinyan LI
;
Caiying PANG
;
Huan HUANG
Author Information
1. 广西中医药大学研究生院,广西 南宁 530200;广西壮族自治区妇幼保健院超声科,广西 南宁 530003
- Publication Type:Journal Article
- Keywords:
Alpha-thalassemia;
Ultrasonography;
Early pregnancy;
Fetus;
Cardiothoracic ratio;
Z-score;
Forecasting
- From:
Chinese Journal of Medical Imaging
2025;33(9):999-1003
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To explore the predictive value of fetal cardiothoracic ratio(CTR)and their Z-scores for homozygous α-thalassemia major in early pregnancy.Materials and Methods Retrospective analysis was conducted on fetuses at high risk of α-thalassemia major(at 11-13?? weeks of gestation)who received prenatal care at the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from June 2016 to December 2023.Ultrasound examinations were performed on these fetuses to measure the CTRs[including cardiothoracic diameter ratio(CTDR),cardiothoracic circumference ratio(CTCR)and cardiothoracic area ratio(CTAR)],which were simultaneously converted into Z-scores.The receiver operating characteristic curve was used to evaluate the predictive efficacy of each group of CTRs and their corresponding Z-scores for fetal α-thalassemia major.Results ①A total of 363 high-risk fetuses were included,including 91(25.1%)in the affected group and 272(74.9%)in the control group.②All the CTRs(including CTDR,CTCR and CTAR)and their corresponding Z-scores in the affected group were significantly higher than those in the control group(t=3.705-21.320,all P<0.001).③The area under the curve(AUC)analysis showed that the AUCs of cardiothoracic ratio Z-scores were higher than those of the corresponding cardiothoracic ratios.The AUCs were ranked from largest to smallest as CTDR Z-score,CTDR,CTAR Z-score,CTCR Z-score,CTAR,CTCR,and the CTDR Z-score had the highest predictive efficacy(when the optimal cut-off value was 1.10,AUC=0.959,with a sensitivity of 94.5%and a specificity of 90.4%).Conclusion The predictive efficacy of fetal CTR Z-scores is higher than that of the corresponding CTRs,which are new indicators for effectively predicting homozygous α-thalassemia major in early pregnancy.Among them,the CTDR Z-score has the highest predictive efficacy,which can improve the prenatal diagnosis rate of this disease and reduce some unnecessary invasive procedures.
