三维能量多普勒超声定量参数对胎盘植入的诊断价值  

Value of quantitative parameters of three-dimensional power Doppler ultrasound in diagnosis of placenta accrete

作　　者：李舒[1] 石惠杰[1] 王颖[1] 王洪玲[1] 李淑媛[1] LI Shu;SHI Hui-jie;WANG Ying;WANG Hong-ling;LI Shu-yuan(Prenatal Diagnosis Center,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院产前诊断中心

出　　处：《哈尔滨医科大学学报》2019年第5期506-509,共4页Journal of Harbin Medical University

基　　金：黑龙江省自然科学基金资助项目(H2015065);黑龙江省教育厅科学技术研究项目(12531358);黑龙江省卫生厅科研课题(2007-232)

摘　　要：目的探讨三维能量多普勒超声的定量参数对胎盘植入的诊断价值。方法选取85例有胎盘植入风险的孕妇,对胎盘行三维能量多普勒超声检查,采用VOCAL软件测量血管化指数(VI)、血流指数(FI)和血管化血流指数(VFI)。以临床及病理检查为金标准,应用ROC曲线评价三维能量多普勒超声的诊断效能,计算敏感性、特异性、准确性、阳性预测值(PPV)、阴性预测值(NPV)。结果①胎盘植入组VI、VFI高于无胎盘植入组(P<0.01),两组FI无明显差别(P=0.514);②构建VI、FI、VFI的ROC曲线,AUC分别为0.946、0.741、0.952;③以VI大于22.835作为胎盘植入的诊断界值,敏感性为85.7%,特异性为94.7%,准确性为91.8%,PPV为88.9%,NPV为93.1%。以VFI大于8.313作为胎盘植入的诊断界值,敏感性为89.3%,特异性为89.5%,准确性为89.4%,PPV为80.6%,NPV为94.4%。结论三维能量多普勒超声的定量参数VI、VFI对胎盘植入具有重要的诊断价值。Objective To investigate the value of quantitative parameters of three-dimensional(3 D) power Doppler ultrasound in the diagnosis of placenta accrete. Methods Eighty-five pregnant women at risk of placenta accrete were examined with 3 D power Doppler ultrasound. vascularisation index(VI), flow index(FI) and vascularisation flow index(VFI) were calculated using VOCAL software. Receiver-operating characteristic(ROC) curve analysis was used to examine the diagnostic performance of 3 D power Doppler ultrasound, with clinical and pathological examination as gold standard. Sensitivity, specificity, accuracy, positive predictive value(PPV) and negative predictive value(NPV) were calculated. Results ①Mean values of VI and VFI were higher in placenta accrete group(P<0.01). FI values were similar in both groups(P=0.514). ②Area under the ROC curves for VI, FI and VFI were 0.946, 0.741 and 0.952, respectively. ③Ⅵ diagnosed placenta accrete with a sensitivity of 85.7%, a specificity of 94.7%, accuracy 91.8%, PPV 88.9% and NPV 93.1% when a cut-off point 22.835 was introduced. VFI had 89.3% sensitivity, 89.5% specificity, 89.4% accuracy, 80.6% PPV and 94.4% NPV when a cut-off point 8.313 was introduced. Conclusion The quantitative parameters of 3 D power Doppler ultrasound(VI and VFI) have a high value in the diagnosisof placenta accrete.

关 键 词：胎盘植入 三维超声 能量多普勒 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]