二维彩色多普勒超声与三维能量多普勒超声对胎盘植入的产前诊断价值  

Value of two-dimension color Doppler and three-dimension power Doppler ultrasound in prenatal diagnosis of placenta implantation

作　　者：朱艺玲[1] 吴淑珠[1] 

机构地区：[1]茂名市妇幼保健院,广东52500

出　　处：《现代医药卫生》2017年第24期3726-3729,共4页Journal of Modern Medicine & Health

摘　　要：目的探讨二维彩色多普勒超声与三维能量多普勒超声(3D-PDU)在产前诊断胎盘植入中的应用价值。方法以2013年10月至2016年12月在该院住院的328例孕产妇为研究对象,回顾性分析其二维超声彩色多普勒超声和3D-PDU声像图。将采用二维超声彩色多普勒诊断的孕产妇列入对照组(192例),采用二维彩色多普勒超声和3D-PDU相结合诊断的孕产妇列入观察组(136例)。统计两组的灵敏度、假阴性率(漏诊率)、特异度和假阳性率(误诊率),关注临床结局,并记录观察组胎盘的血管指数(VI)、血流指数(FI)和血管血流综合指数(VFI)。结果对照组的灵敏度、漏诊率、特异度和误诊率分别为64.29%、35.71%、82.67%和17.33%;观察组的灵敏度、漏诊率、特异度和误诊率分别为95.45%、4.55%、92.11%和7.89%,两组比较,差异均有统计学意义(P<0.05)。观察组中胎盘正常者VI和VFI显著低于胎盘植入者,差异有统计学意义(P<0.05),而胎盘正常者和胎盘植入者FI比较,差异无统计学意义(P>0.05)。结论二维彩色多普勒超声和3D-PDU联用可以明显提高产前诊断胎盘植入的灵敏度和特异度,从而降低漏诊率和误诊率,并且3D-PDU可通过评价产前胎盘血流参数来评估胎盘植入的血管化程度。Objective To discuss the application value of the two-dimension(2D) color Doppler ultrasound and the three-dimension power Doppler ultrasound(3D-PDU) in prenatal diagnosis of placenta implantation.Methods A total of 328 pregnant women hospitalized in this hospital from October 2013 to December 2016 were enrolled as the study subjects.Their ul-trasonograms of 2D color Doppler ultrasound and 3D-PDU were analyzed retrospectively.The pregnant women receiving 2D color Doppler ultrasound diagnosis served as the control group(192 cases) were enrolled into the control group,while the pregnant women receiving the diagnosis of 2D color Doppler ultrasound combined with 3D-PDU were enrolled into the observation group(136 cases).The sensitivity,false negative rate(missed diagnosis rate),specificity and false positive rate misdiagnosis rate in the two groups were performed the statistics.The placental vascular index(VI),flow index(FI) and vascular flow index(VFI) in the observation group were recorded.The attention was paid to clinical outcome.Results The sensitivity,missed diagnosis rate,specificity and misdiagnosis rate in the control group were 64.29%,35.71%,82.67% and 17.33% respectively,while which in the observation group were 95.45%,4.55%,92.11% and 7.89% respectively.VI and VFI of women with normal placenta in the observation group were significantly lower than those of women with placental implantstion,the difference was statistically significant( P < 0.05),but FI had no statistical difference between the normal placenta and placenta implantastion( P > 0.05).Conclusion The combination use of 2D color Doppler ultrasound and 3D-PDU can obviously improve the sensitivity and specificity for diagnosing placenta implantation in order to reduce the missed diagnosis rate and misdiagnosis rate,furthermore 3D-PDU can assess the vascularization degree of placenta implantation by evaluating prenatal placenta blood flow parameters.

关 键 词：胎盘 超声检查 多普勒 彩色 产前诊断 敏感性与特异性 血流动力学 

分 类 号：R714.259[医药卫生—妇产科学]