经腹三维超声产前诊断胎盘植入的临床应用价值

doi:10.3969/j.issn.1006-7795.2019.05.022

首都医科大学学报 ›› 2019, Vol. 40 ›› Issue (5): 781-785.doi: 10.3969/j.issn.1006-7795.2019.05.022

经腹三维超声产前诊断胎盘植入的临床应用价值

张雪娟¹, 吴静¹, 张闻平¹, 周齐², 杨敬春¹

1. 首都医科大学宣武医院超声诊断科, 北京 100053;
2. 首都医科大学宣武医院妇产科, 北京 100053

收稿日期:2019-05-20 发布日期:2019-12-16
通讯作者: 吴静 E-mail:wj4628@163.com

Clinical application value of prenatal diagnosis of placenta implantation by transabdominal three-dimensional ultrasound

Zhang Xuejuan¹, Wu Jing¹, Zhang Wenping¹, Zhou Qi², Yang Jingchun¹

1. Department of Diagnostic Ultrasound, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
2. Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China

Received:2019-05-20 Published:2019-12-16

摘要/Abstract

摘要： 目的探讨经腹三维超声在胎盘植入产前诊断中的应用价值。方法选择在首都医科大学宣武医院就诊具有胎盘植入的高危因素的病例34例，其中31例于产前进行三维超声及磁共振成像（magnetic resonance imaging，MRI）检查，分析其影像学表现及诊断价值。结果三维超声的敏感度为77.8%、特异度为68.8%及准确性74.2%均略优于MRI的敏感度50.0%、特异度60.0%及准确性54.8%，三维超声与临床诊断的标准具有较好的一致性（Kappa值=0.617），胎盘后方低回声带消失（77.8%）、胎盘基底部血流增多（66.7%）在胎盘植入病例声像图中较为多见。三维超声和MRI联合诊断胎盘植入的准确性为87.1%，明显高于三维超声（74.2%）及MRI （54.8%）单独诊断的准确性。结论三维超声对胎盘植入诊断具有优势，联合MRI检查，可明显提高对胎盘植入的诊断准确性。

关键词: 三维超声, 胎盘植入, 前置胎盘

Abstract: Objective To explore the application value of the abdominal three dimensional (3D) ultrasound in the prenatal diagnosis of the placenta implantation. Methods Retrospective analysis of 34 cases with placental implantation risk factors in our hospital were selected, 31 of them received prenatal 3D ultrasound and magnetic resonance imaging (MRI) examination. The imaging findings and diagnostic value were analyzed. Results The results showed that the sensitivity 77.8%,specificity 68.8% and accuracy 74.2% of 3D ultrasound were slightly superior to the sensitivity 50.0%,specificity 60.0% and accuracy 54.8% of MRI,3D ultrasound was consistent with the standard of surgery or pathological diagnosis(Kappa=0.617),moreover,the ultrasonic characteristics of the hypoecho area disappeared behind the placenta(77.8%)and increased blood flow at the base of the placenta(66.7%)were more common in the case of placental implantation.The accuracy of the combined diagnosis of placenta implantation by 3D and MRI was 87.1%,which was significantly higher than that by 3D ultrasound (74.2%) and MRI (54.8%). Conclusion 3D ultrasound has significant advantages in the diagnosis of the placenta implantation.Combined MRI examination can significantly improve the diagnostic accuracy of placental implantation.

Key words: 3D ultrasound, placenta implantation, placenta previa

中图分类号:

R445

张雪娟, 吴静, 张闻平, 周齐, 杨敬春. 经腹三维超声产前诊断胎盘植入的临床应用价值[J]. 首都医科大学学报, 2019, 40(5): 781-785.

Zhang Xuejuan, Wu Jing, Zhang Wenping, Zhou Qi, Yang Jingchun. Clinical application value of prenatal diagnosis of placenta implantation by transabdominal three-dimensional ultrasound[J]. Journal of Capital Medical University, 2019, 40(5): 781-785.

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经腹三维超声产前诊断胎盘植入的临床应用价值

Clinical application value of prenatal diagnosis of placenta implantation by transabdominal three-dimensional ultrasound

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