摘要
目的探讨产前二维彩色多普勒超声(2D-CDFI)联合三维彩色能量血管成像(3D-CPA)在胎盘植入诊断中的临床应用价值及其图像特征。方法选择2010年9月至2015年8月在深圳市龙岗中心医院临床检查疑诊子宫胎盘植入的患者43例,行产前常规2D-CDFI超声和3D-CPA检查。依据产时临床诊断和产后临床病理检查结果,总结胎盘植入患者2D-CDFI、3D-CPA图像特征及临床应用价值。结果产前临床疑诊胎盘植入的43例患者,结合临床、超声及手术病理检查结果确诊胎盘植入29例,其中粘连性胎盘3例,植入性胎盘24例,穿透性胎盘2例,其余14例无胎盘植入。29例胎盘植入患者产前2D-CDFI主要表现为胎盘后间隙消失、胎盘增厚、内见多个血池形成;超声诊断胎盘植入19例,无胎盘植入误诊为胎盘植入6例,漏诊胎盘植入4例;与临床病理诊断符合率为65.5%(19/29)。产前3D-CPA显示胎盘基底部血管与子宫肌层血管相互交错分布,胎盘内血管紊乱,血流丰富呈网状;产前超声正确诊断胎盘植入23例,误诊3例,漏诊胎盘植入3例;与临床病理诊断符合率为79.3%(23/29)。产前2D-CDFI联合3D-CPA正确诊断28例,漏诊胎盘植入1例,与临床病理诊断符合率为96.6%(28/29)。结论 2D-CDFI及3D-CPA在胎盘植入产前诊断中均有特征性超声表现,且3D-CPA可清晰显示胎盘植入范围及血管侵入深度,在胎盘植入诊断上较二维超声及2D-CDFI更具优势,有较好的临床应用价值。
Objective To explore the value of two dimentional colour Doppler flow image （2D-CDFI） combined with three-dimensional color power angiography （3D-CPA） in diagnosis of placenta accreta. Methods A total of 43 pregnant women at risk of placenta accreta selected from September 2010 to August 2015 were enrolled, and underwent 2D-CDFI and 3D-CPA to scan entire placenta. Taking the results of clinical outcome and delivery pathology of the placenta as standard, the ultrasound characteristics of 2D-CDFI and 3D-CPA were analyzed. Results Taking the results of clinical outcome and delivery pathology of the placenta as standard, 24 were proved with placenta increta, 3 patients with adherent placenta, 2 patients with placenta percreta, 14 patients with no placenta implantation. Out of 43 cases, 29 cases displayed the placental thickening and rich blood vessels in placenta, and at interface of placenta and bladder wall in 2D-CDFI. For 2D-CDFI, 19 cases were correctly diagnosed with placenta accrete, while 6 cases were mis-diagnosed and 4 cases missed diagnosed, the diagnosis coincidence rate by 2D-CDFI was 65.5% （19/29）. The ultrasound characteristics displayed irregular arranged myometrial arcuate artery, rich blood vessels at interface of placenta and bladder wall in 3D-CPA. For 3D-CPA, 23 cases were correctly diagnosed with placenta accrete, 3 cases were misdiagnosed, the diagnosis coincidence rate by 3D-CPA was 79.3% （23/29）. For 3D-CPA combined 2D-CDFI, l case missed diagnosed, the diagnosis coincidence rate by combination 2D-CDFI with 3D-CPA was 96.6% （28/29）. Conclusions Placenta accrete can all be prenatally diagnosed by characteristic ultrasonic features of 2D-CDFI and 3D-CPA. But 3D-CPA can clearly display the range of placenta accrete lesions and the depth of the blood vessels diffused, has more advantage than two-gray scale ultrasound and 2D-CDFI and has broad application in clinic.
出处
《中华医学超声杂志（电子版）》
CSCD
2017年第2期117-121,共5页
Chinese Journal of Medical Ultrasound(Electronic Edition)
基金
基金项目 深圳市龙岗区科技发展资金医疗卫生类(20160606173322650)
关键词
超声检查
三维
三维彩色能量成像
胎盘植入
诊断
Ultrasonography, three-dimensional
Three-dimensional color power angiography
Placenta accrete
Diagnosis
