三维彩色能量成像对植入型凶险性前置胎盘的诊断价值  

Diagnostic value of three-dimensional color power angio in pernicious placenta previa with placenta increta

作　　者：刘晓[1] 于冰[1] 

机构地区：[1]山西医学科学院山西大医院妇产科超声室,太原030032

出　　处：《中华超声影像学杂志》2015年第6期522-524,共3页Chinese Journal of Ultrasonography

摘　　要：目的探讨三维彩色能量成像（3D-CPA）在植入型凶险性前置胎盘（PPP）产前诊断中的价值。方法回顾分析我院诊断的34例植入型PPP的产前二维彩色多普勒超声（2D-CDFI）及3D-CPA表现，并与产后病理结果进行对照，总结二者对PPP的灵敏度、特异度、阳性预测值及产前检出率。结果2D-CDFI诊断植入型PPP的灵敏度、特异度分别为76．4％、66．7％，阳性预测值为81．5％；3D-CPA诊断植入型PPP的灵敏度、特异度分别为91．1％、88．9％，阳性预测值达93．3％，差异有统计学意义（P〈0．05）；3D-CPA产前检出率90．4％（47／52）高于2D-CDFI检出率73．0％（38／52），差异有统计学意义（P〈0．05）。结论3D-CPA可从多方面多角度显示胎盘与宫壁之间的异常血管重建，提高植入型PPP的产前超声诊断率，在产前植入型PPP的诊断中具有重要临床价值。Objective To investigate the value of three-dimensional color power angio（3D-CPA） in the prenatal diagnosis of pernicious placenta previa （PPP） with placenta increta. Methods The ultrasonographic findings of PPP with placenta increta diagnosed in our hospital by 2D-CDFI and 3D-CPA were reviewed and compared with pathologic histology examination. For each of the two imaging methods, sensitivity, specificity, positive predictive value and prenatal diagnose accordance rate were summarized. Results For 3D-CPA, sensitivity, specificity and positive predictive value were 91.1%,88.9% and 93.3%, respectively. The results of 3D-CPA were higher than those in 2D-CDFI （sensitivity 76.4%, specificity 66.7% ,positive predictive value 81.5% ）, and were statistically significant （P 〈 0.05）. The diagnose accordance rate of 3D-CPA was statistically higher than that of 2D-CDFI （90.4% vs 73.0%; P 〈0.05）. Conclusions 3D-CPA can display abnormal vascular reconstruction between the placenta and uterine wall from various angles,and is more accurate than 2D-CDFI. 3D-CPA plays an important role in the prenatal diagnosis of PPP with placenta increta.

关 键 词：超声检查 前置胎盘 侵入性胎盘 

分 类 号：R714.2[医药卫生—妇产科学] R445.1[医药卫生—临床医学]