三维能量多普勒血管成像技术在脐带异常附着中的应用价值

The Value of Three-dimensional Power Doppler Angiography in Detecting Abnormal Umbilical Cord Insertions

目的:评估三维能量多普勒血管成像技术(three-dimensional power doppler angiography,3D-PDA)判断脐带附着位置及相关并发症的应用价值。方法:选取2010年1月至2012年6月中孕早期及中孕期在我院超声科检查并经二维彩色多普勒超声可疑为脐带异常附着160例,应用3D-PDA进一步检测其脐带附着情况,并对各病例进行随访、追踪,产后留取新鲜、完整胎盘及脐带,明确脐带附着情况。结果:160例病例中,产后大体病理确诊球拍状胎盘(脐带边缘附着)113例,帆状胎盘20例,副胎盘5例,共138例。3D-PDA诊断脐带附着异常共136例,除2例脐带边缘附着漏诊外其余分型与产后病理结果一致。结论:3D-PDA能准确、直观显示脐带附着点及其附近脐血管的走行情况,在脐带边缘附着、帆状附着、血管前置的诊断方面有重要作用。

Objective To evaluate the value and the accuracy of three-dimensional power doppler angiography（3D-PDA） in detecting the position that the umbilical cord attached to and the ralated complications.Methods We chose 160 cases as our objects in the study.The cases were doubt with abnormal umbilical cord insertions by 2D Color doppler ultrasound when undergoing ultrasound examination at second trimester in our hospital from January 2010 to June 2012.We applied 3D-PDA to detecting the insertion situation of the umbilical cord further.All the cases were followed up.We maked a definite diagnosis about umbilical cord insertions by examining the fresh,complete placenta and umbilical cord after delivery.Results In pathologic findings,113 cases had battledore shaped placentae（marginal cord insertions）,20 cases had placenta velamentous,5 cases had succenturiate placenta.136 cases had sonographically abnormal insertions by 3D-PDA.Except that 2 cases with marginal cord insertions were missed diagnosis by 3D-PDA,the types of abnormal insertions of other cases were coincident with pathologic findings.Conclusion The images of three-dimensional power doppler angiography acurately,visually display the site of umbilical cord insertion and the vessels distribution in the placental.3D-PDA plays an important role in the diagnosis of marginal cord insertion、Velamentous cord insertion and vascular previa.