应用足底平面第一与第五跖骨夹角评价胎儿先天性足内翻

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Abstract Objective: Discuss the value of the angle between the first and fifth metatarsal bones on plantar plane in diagnosis of fetal congenital clubfoot. Methods: There were 186 feet of 117 fetuses with gestational age from 19 to 37 weeks in control group. There were 37 feet from 24 fetuses which were suspected with congenital clubfoot in case group. Use TUI mode to measure the angle between the first and fifth metatarsal bones on plantar plane, and analyze the correlation between the angle and the gestational age. Compare the results with the case group and use ROC curve to judge its diagnostic value. The fetuses in case group were followed to obtain the pregnancy outcomes and confirm whether the deformity existed. DR examination was used to measure the angle of bilateral feet of the fetuses with congenital clubfoot on postero-anterior view. Compare the results with ultrasonic measurement and calculate Kappa value. Results: The angle between the first and fifth metatarsal bones on plantar plane in control group was (22.83±2.07)°. It had no obvious correlation with gestational age(r=0.104, P=0.158>0.05). The angle of case group was (32.91±3.30)°, and compared with control group, the difference is statistically significant(P=0.000<0.05). The area under ROC curve was 0.978, the cut-off was 27.47° with sensitivity of 94.6% and specificity of 97.8%. The angle of normal feet and clubfoot under DR check were (23.28±1.16)°, (33.59±3.02)°, the differences had no statistically significant between ultrasonic measurements and DR check(P=0.471>0.05, P=0.281>0.05). The Kappa value of measure of agreement were 0.811 and 0.894(P=0.000<0.05). Conclusions: The angle between the first and fifth metatarsal bones on plantar plane has no obvious correlation with gestational age. Compare to the normal fetuses, the angle of fetal congenital clubfoot between the first and fifth metatarsal bones increases obviously.

Key words： Clubfoot Fetal diseases Ultrasonography, prenatal

Received: 20 April 2015

PACS:	Ｒ714.53
	Ｒ445.1

Corresponding Authors: CAI Ai-lu

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	DING Hao
	WANG Yu
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	WANG Bing
	HAN Bing

Cite this article:

DING Hao,WANG Yu,CAI Ai-lu, et al. Value of the angle between the first and fifth metatarsal bones on plantar plane in#br# prenatal diagnosis of fetal congenital clubfoot[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2015, 26(11): 812-815.

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2015/V26/I11/812

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