彩色多普勒超声诊断胎盘植入的价值  

The Value of Color Doppler Ultrasound in Diagnosis of Placenta Accrete

作　　者：王玲红[1] 武超[1] 

机构地区：[1]天津市中心妇产科医院,300100

出　　处：《国际妇产科学杂志》2014年第3期280-281,F0003,共3页Journal of International Obstetrics and Gynecology

摘　　要：目的:评价彩色多普勒超声诊断胎盘植入的价值。方法:回顾性分析2012年1月—2013年10月在天津市中心妇产科医院超声诊断胎盘低置状态或低置胎盘或前置胎盘的住院患者93例,其中超声检查疑似胎盘植入者24例。经腹部超声及阴道超声着重扫查胎盘的位置及其厚度、胎盘内回声、胎盘附着处子宫肌层厚度及其与子宫肌层的关系、与子宫相邻的膀胱壁情况、胎盘附着处血流情况。结果:24例经彩色多普勒超声检查疑似胎盘植入,经手术病理确诊为胎盘植入20例,其中粘连性胎盘4例,植入性胎盘14例,穿透性胎盘2例。超声误诊5例,漏诊1例。彩色多普勒超声检查的敏感度为95.00%,特异度为93.15%,阳性预测值为79.17%,阴性预测值为98.55%。结论:彩色多普勒超声为产前检查胎盘植入的较好方法。Objective：To evaluate the value of color Doppler ultrasound in the diagnosis of placenta accreta. Methods：Retrospective analysis of 93 cases diagnosed as placenta low state ,low-lying placenta or placenta previa through ultrasound examination in our hospital between January 2012 to October 2013. 24 cases were diagnosed as placenta implantation among them. Abdominal and transvaginal ultrasonography focus in observing the thickness ,position and internal echo of the placenta , the thickness of uterine muscle in placental site ,the relationship between the placenta and uterine muscle ,and the adjacent urinary bladder wall blood flow in placental site were also included. Results：24 patients were suspected of placenta implantation by color Doppler ultrasonography,20 cases were confirmed of placenta implantation by pathology after operation,including 4 cases of placenta adherence,14 cases of placenta accreta,2 cases of placenta penetration.,5 cases of misdiagnosis, missed diagnosis in 1 cases. Sensitivity and specificity of color Doppler ultrasonography was 95.00% and 93.15% respectively. The positive predictive value and the negative predictive value of color Doppler ultrasonography was 79.17% and 98.55%respectively. Conclusions：The color Doppler ultrasound is a preferred method for prenatal diagnosis of placenta accreta.

关 键 词：胎盘 侵入性 超声检查 多普勒 彩色 前置胎盘 产前诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]