發(fā)布時(shí)間：2018-11-08 12:18

【摘要】：目的探討聯(lián)合應(yīng)用二維灰階超聲、CDFI及三維能量超聲對(duì)胎盤植入的產(chǎn)前診斷價(jià)值。方法選取瘢痕子宮和(或)有其他子宮手術(shù)史的191例前置胎盤孕婦,應(yīng)用二維灰階超聲、CDFI及三維能量超聲掃查整個(gè)胎盤。以產(chǎn)時(shí)臨床診斷和產(chǎn)后病理結(jié)果為金標(biāo)準(zhǔn),比較產(chǎn)前超聲診斷胎盤植入的效能。結(jié)果 191例中,粘連性胎盤13例,植入性胎盤16例,穿透性胎盤14例。單獨(dú)采用二維灰階超聲、CDFI、三維能量超聲診斷植入性胎盤和穿透性植入的敏感度、特異度、陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值分別為90.00%(27/30)、91.30%(147/161)、65.85%(27/41)、98.00%(147/150),86.67%(26/30)、93.79%(151/161)、72.22%(26/36)、97.42%(151/155)和96.67%(29/30)、96.89%(156/161)、85.29%(29/34)、99.36%(156/157)。3種方法聯(lián)合應(yīng)用檢測(cè)植入性胎盤和穿透性胎盤的敏感度、特異度、陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值為100%(30/30)、98.76%(159/161)、93.75%(30/32)、100%(159/159)。結(jié)論在產(chǎn)前植入性胎盤和穿透性胎盤的診斷中,聯(lián)合應(yīng)用二維灰階超聲、CDFI及三維能量超聲,一定程度上可避免漏診,三維能量超聲可作為二維灰階超聲和CDFI的補(bǔ)充診斷方法。
[Abstract]:Objective to evaluate the value of two-dimensional gray scale ultrasound, CDFI and three-dimensional energy ultrasound in prenatal diagnosis of placenta accreta. Methods the placenta previa was examined by two-dimensional gray-scale ultrasound, CDFI and three-dimensional energy ultrasound in 191 pregnant women with scar uterus and / or other uterine operation. The efficacy of prenatal ultrasound in the diagnosis of placenta accreta was compared according to the results of clinical diagnosis and postpartum pathology. Results among 191 cases, 13 cases were adherent placenta, 16 cases were accreta placenta, and 14 cases were penetrating placenta. The sensitivity, specificity, positive predictive value and negative predictive value were 90.00% (27 / 30) and 91.30% (147 / 161), respectively. 65.85% (27 / 41), 98.00% (147 / 150), 86.67% (26 / 30), 93.79% (151 / 161), 72.22% (26 / 36), 97.42% (151 / 155) and 96.67% (2930%) 96.89% (156 / 161), 85.29% (29 / 34), 99.36% (156 / 157). Negative predictive values were 100% (30 / 30), 98.76% (159 / 161), 93.75% (30 / 32), 100% (159 / 159). Conclusion in prenatal diagnosis of placenta accreta and penetrating placenta, combined use of two-dimensional gray-scale ultrasound, CDFI and three-dimensional energy ultrasound can avoid missed diagnosis to some extent. Three-dimensional energy ultrasound can be used as a supplementary diagnostic method for two-dimensional gray-scale ultrasound and CDFI.
【作者單位】： 九江市第一人民醫(yī)院超聲科;南昌大學(xué)第一附屬醫(yī)院超聲科;
【分類號(hào)】：R445.1;R714.462

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