三维能量多普勒超声对胎盘植入患者的临床诊断价值分析  

Analysis of clinical diagnostic value of three dimensional energy Doppler ultrasound in patients with placenta accreta

作　　者：凌思卓[1] 曾海文 刘滨月[1] LING Si-zhuo;ZENG Hai -wen;LIU Bin -yue(Department of Ultrasonography,Longgang Central Hospital,Shenzhen Guangdong 518000.P.R.China)

机构地区：[1]深圳市龙岗中心医院超声科,广东深圳518116

出　　处：《中国计划生育和妇产科》2018年第12期56-59,F0004,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：深圳市龙岗区经济与科技发展专项资金-医疗卫生科技计划项目(项目编号:201620475)

摘　　要：目的探讨三维能量多普勒超声(3D power doppler ultrasound,3D-PDU)在胎盘植入患者临床诊断中的应用价值。方法选取2015年1月至2017年10月深圳市龙岗中心医院妇产科收治的伴有胎盘植入高危因素的48例疑似胎盘植入患者为研究对象,观察3D-PDU对胎盘植入的诊断结果与"金标准"之间的一致性。结果 48例可疑胎盘植入患者有35例(72.92%)经术后病理检查和临床综合诊断确诊为胎盘植入;3D-PDU检查结果为34例(70.83%)胎盘植入,其诊断敏感度为85.71%,特异度为69.23%,诊断符合率为81.25%。两种诊断方法具有较好的一致性(Kappa值为0.536,P <0.01)。胎盘植入组患者血管化指数(vascularization index,VI)、血流指数(flow index,FI)及血管化血流指数(vascularization-flow index,VFI) 3个指标参数较无胎盘植入患者升高,差异有统计学意义(P <0.05)。结论 3D-PDU能够直观、形象地显示胎盘血流情况,利用三维立体重建软件可提供胎盘血管立体分布情况和量化指标,有效提高了胎盘植入诊断率,对胎盘植入早期诊断及临床预后具有重要意义。Objective To evaluate the clinical value of 3 D power doppler ultrasound(3 D-PDU) in the diagnosis of placental accreta.Methods 48 suspected placenta accreta patients with high-risk factors of placenta implantation in the Department of Gynaecology and Obstetrics of Longgang Central Hospital from January 2015 to October 2017 were selected.The consistency between the 3 D-PDU and the " gold standard" for the diagnosis of placenta accreta was observed and compared.Results In 48 cases of suspected placental accreta,35 cases(72.92 %) were diagnosed as placental accreta by postoperative pathological examination and clinical comprehensive diagnosis.The results of 3 D-PDU examination were 34 cases(70.83 %) of placenta accreta,the diagnostic sensitivity was 85.71 %,the specificity was 69.23 %,and the diagnostic accordance rate was 81.25 %.The two diagnostic methods had good consistency(Kappa value was 0.536,P<0.01).The 3 index parameters of VI,FI and VFI in the placenta implantation group were higher than those without placental accreta,and the difference was statistically significant(P<0.05).Conclusion 3 D-PDU can directly and vividly display the blood flow of the placenta.The three-dimensional reconstruction software can provide three-dimensional distribution of placental blood vessels and can provide quantitative indicators to effectively improve the diagnostic rate of placenta accreta.3 D-PDU plays an important role in the early diagnosis of placenta accreta and clinical prognosis.

关 键 词：三维能量多普勒超声 胎盘植入 产前检查 临床诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]