超声造影诊断胎盘病变的应用研究  

Application of contrast-enhanced ultrasonography in diagnosis of placenta disease

作　　者：路小军[1] 李建华[1] 段明娟[1] 杜敏[1] 何莎[1] 陈欣林[1] 

机构地区：[1]湖北省妇幼保健院超声科,武汉430070

出　　处：《中华医学超声杂志（电子版）》2010年第11期71-75,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：湖北省自然科学基金项目(编号:2009CDZ025)

摘　　要：目的探讨超声造影在胎盘病变诊断中的应用价值。方法对16例胎儿有致命性畸形或宫内无法存活并疑有胎盘病变均需终止妊娠的患者行超声造影检查,观察胎盘实时超声造影过程,并运用SonoliveR CAP造影分析软件显示胎盘的灌注特征,分析胎盘内造影剂灌注特征。结果 16例胎盘造影全过程中未见造影剂进入脐血管和胎儿体内;16例患者胎盘中5例形态正常且无灌注缺失,其灌注表现为造影剂从子宫浆膜层到胎盘基底部,再到母体侧胎盘小叶顺序灌注,并迅速融合,直到胎盘全部灌注;余11例胎盘超声造影表现:9例呈不同程度的局部或大部灌注缺失,2例灌注顺序异常。结论实时超声造影显示了胎盘血液灌注过程以及胎盘植入、胎盘内造影剂灌注缺失的特征,对了解胎盘灌注情况及胎盘病变及临床诊断母亲先兆子痫、胎儿生长受限提供了重要的信息。Objective To explore the value of contrast-enhanced ultrasonography in diagnosis of placenta disease.Methods The 16 fetuses were those with fatal abnormity or could not survive in uterus and then needed to be terminated pregnancy,simultaneously the patients could have placenta disease.A real-time CEUS was performed to observe the whole process in the placenta by applying the SonoliverR CAP software to explore more about the perfusion characteristics of the placenta,and to analyze the perfusion characteristics of the agents in the placenta.Results Of all 16 cases,in the CEUS progress there was no agent entering into the umbilical vessel and the fetus.Five cases of the 16 placentas perfusion order were normal form without perfusion absence,The contrast-enhanced agent was shown to arrive at the serosal layer of the uterus firstly,then to basilar part,at last it reached the cytoledon of the mother side and fused quickly,until the whole placenta had contrast-enhanced agent.The CEUS characteristics of 11 cases showed that in the placentas had part or most part of perfusion absence 9 cases,2 cases had abnormal perfusion sequence.Conclusion The real-time contrast-enhanced ultrasonography appeared the hemoperfusion progress of the placenta,which could provide the feature of the placenta increta and the perfusion absence,the important information on the hemoperfusion of the placenta help understand the placenta disease and diagnose the preeclampsia of the mother and the fetal growth restriction.

关 键 词：超声检查 胎盘病变 造影剂 灌注缺失 

分 类 号：R445.1[医药卫生—影像医学与核医学]