胎盘植入相关超声图像特征的产前诊断价值  

The Prenatal Diagnostic Value of Sonographic Characteristics in Placental Implantation

作　　者：章婷[1] 于利利[1] 张璇[1] 陈汉荣[1] 王泽华[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院妇产科超声科,武汉市430030

出　　处：《中国超声医学杂志》2016年第5期451-453,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨胎盘植入相关超声图像特征在产前诊断中的价值。方法以70例在我院行产前超声检查疑似胎盘植入并在我院生产的孕妇为研究对象,回顾性分析患者病例、超声报告及图像。确诊以生产中所见及病理结果为准。结果在胎盘植入的产前诊断中,各图像特征(胎盘后方间隙消失、胎盘内广泛腔隙、胎盘内局灶腔隙、胎盘后方血流丰富、子宫膀胱壁界面毛糙)的灵敏度(特异度)分别为71.2%(18.2%)、35.6%(100%)、33.9%(36.4%)、42.4%(81.8%)、18.6%(90.9%)。在对产后子宫切除的预测中,各图像特征的灵敏度(特异度)分别为63.2%(23.5%)、63.2%(82.4%)、21.1%(54.9%)、68.4%(72.5%)、36.8%(90.2%)。结论胎盘植入各图像特征中,胎盘后方间隙消失灵敏度高而特异度低,容易造成误诊,而胎盘内广泛腔隙特异度高,且对预测产后子宫切除灵敏度高,在胎盘植入的产前诊断中具有重要价值。Objective To discuss the value of placenta implantation related sonographic characteristics in prenatal diagnosis.Methods We retrospectively reviewed the medical records and ultrasound reports of 70 patients referred for suspected placenta accrete by prenatal ultrasound and delivered in our hospital.Placenta accreta was defined by clinical criteria at the time of delivery and by pathologic findings.Results The sonographic characteristics including：loss of the normal retroplacental clear space,more lacuna,fewer lacuna,Doppler abnormality,irregularity of uterine-bladder interface,their sensitivities（specificities）in the diagnosis of placenta implantation were 71.2%（18.2%）,35.6%（100%）,33.9%（36.4%）,42.4%（81.8%）,18.6%（90.9%）respectively,and their sensitivities（specificities）in predicting hysterectomy were 63.2%（23.5%）,63.2%（82.4%）,21.1%（54.9%）,68.4%（72.5%）,36.8%（90.2%）respectively.Conclusions In all sonographic characteristics of placenta implantation,loss of the normal retroplacental clear space had high sensitivity and low specificity,easy to misdiagnosis,and its correct recognition is closely related to the experience of operator.More lacuna could recognize placental implantation in high specificity,and predict serious adverse pregnancy outcomes in high sensitivity,so had important value in the prenatal diagnosis of placental implantation.

关 键 词：胎盘植入 超声 产前诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.462[医药卫生—诊断学]