超声评分法联合子宫弓状动脉收缩期峰值血流速度参数值对凶险性前置胎盘孕妇胎盘植入的预测价值研究  

Study on the predictive value of ultrasound scoring combined with the PSV parameter value of uterine arcuate artery on the PA of pregnant women with PPP

作　　者：张利 尚晓娜 孙临华[1] 王峻 ZHANG Li;SHANG Xiao-na;SUN Ling-hua(Department of Ultrasound Medicine,Baoji Central Hospital,Baoji 721008,China)

机构地区：[1]宝鸡市中心医院超声医学科,陕西宝鸡721008 [2]陕西省第二人民医院超声医学科,陕西西安710000

出　　处：《中国医学装备》2020年第12期76-80,共5页China Medical Equipment

基　　金：陕西省医学科研计划(SY2018N73)“凶险前置胎盘产妇胎盘植入风险预警模型的构建与临床应用”。

摘　　要：目的:研究超声征象评分法联合子宫弓状动脉收缩期峰值血流速度(PSV)参数值对凶险性前置胎盘(PPP)胎盘植入(PA)的临床预测价值。方法:选取163例经腹部超声检查确诊的孕晚期PPP孕妇,根据手术或病理结果将其分为PA组(76例)和非PA组(87例)。对比探究超声评分法联合子宫弓状动脉血流参数值对前置PA的预测价值。结果:PA组患者超声检查总评分≥3分为超声征象评分法诊断PA的最佳诊断界点,其受试者工作特征(ROC)曲线下面积(AUC)值为0.932,灵敏度和特异度分别为87.27%和92.60%。PA组子宫弓状动脉血流参数PSV值高于非PA组,搏动指数(PI)和阻力指数(RI)低于非PA组,差异有统计学意义(t=10.877,t=5.573,t=9.802;P<0.001)。子宫弓状动脉血流参数ROC曲线显示PSV诊断价值最高,其AUC值为0.907,灵敏度和特异度分别为90.06%和83.42%。超声征象评分法联合子宫弓状动脉PSV参数诊断PA的AUC值为0.967,灵敏度94.44%,特异度95.41%。结论:超声征象评分法联合子宫弓状动脉血流参数PSV诊断前置PA的诊断效力优于单个诊断方法,临床诊断价值较高。Objective:To explore the clinically predictive value that ultrasound sign scoring combined with the parameter value of peak systolic velocity(PSV)of uterine arcuate artery on the placenta accrete(PA)of pregnant women with pernicious placenta previa(PPP).Methods:163 women with PPP in later stages of pregnancy were confirmed by abdominal ultrasound were selected and divided into PA group(76 cases)and non-PA group(87 cases)according to surgical or pathological results.And then the predictive value of ultrasound scoring combined with blood flow parameter value of uterine arcuate artery for PA of preposition was compared and explored.Results:In the PA group,the total score of ultrasound examination was larger than or equal to 3 was the optimal diagnostic threshold for PA as ultrasound sign scoring method.The area under curve(AUC)of receiver operating characteristics(ROC)curve was 0.932,and the sensitivity and specificity were 87.27%and 92.60%,respectively.And the PSV value of blood flow parameters of uterine arcuate artery in PA group was significantly higher than that in non-PA group,and the pulsation index(PI)and resistance index(RI)of PA group were significantly lower than those of non-PA group(t=10.877,t=5.573,t=9.802,P<0.001).The ROC curve of blood flow parameter of uterine arcuate artery showed that the diagnostic value of PSV was the highest,and its AUC value was 0.907,and the sensitivity and specificity were 90.06%and 83.42%,respectively.The AUC value,sensitivity and specificity that ultrasound sign scoring combined PSV parameter of uterine arcuate artery in diagnosing PA of preposition were 0.967,94.44%and 95.41%respectively.Conclusion:The diagnostic efficacy that ultrasound sign score combines with PSV blood flow parameter of uterine arcuate artery in diagnosing PA of position is superior to that of single diagnostic method,and its clinical diagnosis value is higher.

关 键 词：超声征象 子宫弓状动脉PSV参数值 前置胎盘 胎盘植入(PA) 

分 类 号：R445.1[医药卫生—影像医学与核医学]