常规超声联合超声造影对产后胎盘植入性疾病的诊断及误诊分析  

Diagnosis and misdiagnosiss analysis of postpartum placenta accreta spectrum disorders by conventional ultrasound combined with contrastenhanced ultrasound

作　　者：韦爱华[1] 穆靓[1] 陈浩 南淑良 刘莉[1] 彭建美[1] 管湘平[1] Wei Aihua;Mu Liang;Chen Hao;Nan Shuliang;Liu Li;Peng Jianmei;Guan Xiangping(Ultrasound Diagnosis Center,Shaanxi Provincial People's Hospital,Xi'an Shaanxi 710068;Graduate Ofice,Xi'an Medical University,Xi'an Shaanxi 710021,P.R.China)

机构地区：[1]陕西省人民医院超声诊断中心,陕西西安710068 [2]西安医学院研究生院,陕西西安710021

出　　处：《中国计划生育和妇产科》2023年第7期81-84,I0004,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：陕西省重点研发计划项目(项目编号:2021SF-199);陕西省卫生健康科研基金项目(项目编号:2021D028)。

摘　　要：目的探讨常规超声及超声声学造影(contrast enhanced ultrasound,CEUS)在产后胎盘植入性疾病(placenta accreta spectrum disorders,PAS)诊断中的应用价值及误诊分析。方法选取2018年8月至2022年7月在陕西省人民医院产科住院的126例临床拟诊宫腔残留患者,所有产妇依次行常规超声及CEUS检查,并经临床病理证实。分析比较两种方法诊断PAS的灵敏度、特异度、准确率,以及误诊分析。结果126例患者中,最终临床病理结果证实109例PAS,17例无PAS、仅宫腔胎盘滞留。常规超声联合CEUS诊断PAS的灵敏度、特异度以及诊断准确率分别为96.33%、70.59%及92.86%,常规超声诊断PAS的灵敏度、特异度及准确率分别为80.73%、35.29%及74.60%,二者比较差异均有统计学意义(P<0.05)。结论仑CEUS结合常规超声检查,能够客观显示产后宫腔胎盘微血流灌注,判断宫腔内胎盘回声是否合并PAS及胎盘植入的部位和范围,具有更高的诊断价值。Objective To explore the application value and misdiagnosis analysis of conventional ultrasound and contrast enhanced ultrasound(CEUS)in the diagnosis of postpartum placenta accreta spectrum disorders(PAS).Methods From August 2018 to May 2022,126 patients suspected residue placenta in the Department of Obstetrics of Shaanxi Provincial People's Hospital were examined by conventional ultrasound and CEUS,which were confirmed by clinical pathology.Analyzed and compared the sensitivity,specificity,accuracy and misdiagnosis analysis of the two methods in the diagnosis of PAS.Results Among the 126 patients,the final pathological results confirmed 109 cases with PAS,and 17 cases without PAS,only placenta retention.The sensitivity,specificity and accuracy of conventional ultrasound combined with CEUS in the diagnosis of PAS were 96.33%,70.59%and 92.86%respectively.The sensitivity,specificity and accuracy of conventional ultrasound were 80.73%,35.29%and 74.60%respectively.There were significant differences(P<0.05).Conclusion CEUS combined with conventional ultrasound showed the blood flow perfusion of postpartum placenta,and judge whether the placental echo in the uterine cavity is combined with PAS and give the location and extent of placenta accreta,which has higher diagnostic value.

关 键 词：常规超声 超声声学造影 胎盘植入 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]