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超声造影对产后胎盘植入分型诊断的探讨 被引量:12

Value of contrast-enhanced ultrasonography in diagnosis typing of placenta accrete
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摘要 目的探讨超声造影在产后胎盘植入分型诊断中的作用。方法对临床诊断产后胎盘植入的31例产妇行超声造影检查,与二维彩色多普勒比较,并与术后结局作对照。结果二维彩色多普勒和超声造影均可显示31例残留胎盘大小,但超声造影能更清楚地显示胎盘与子宫的边界、胎盘内富血流区和乏血流区。二维彩色多普勒提示7例粘连型,23例植入型,1例穿通型。根据造影图像肌层厚度和造影剂灌注消退时间,造影提示11例粘连型,16例植入型,4例穿通型。手术结果:10例粘连型,21例植入型和穿通型。二维彩色多普勒的分型误判率为19.4%,造影的分型误判率为6.5%,造影分型诊断与术后结局一致性较高,Kappa系数0.859,Pd0.001。结论超声造影判别产后胎盘植入类型的准确率较二维彩色多普勒高,对临床怀疑产后胎盘植入者行超声造影检查能提高诊断的准确性和可靠性,为临床选择治疗方式提供参考依据。 Objective To assess the value of contrast-enhanced ultrasound (CEUS) in diagnosing subtypes of postpartum placenta accreta. Methods 31 puerperal clinically diagnosed of postpartum placenta accreta were collected. They were inspected by using CEUS and 2-dimensional color Doppler ultrasound, respectively. The operation was used as a reference. Results Both 2-dimensional color Doppler and CEUS could identify the sizes of residual placenta for the patients, but CEUS showed more explicit boundary for placenta and uterus and the rich/poor blood flow areas in the placenta. Among the 31 patients, 7,23 and 1 were classified of accreta, increta and percreta, respectively, by using 2-dimensional color Doppler ultrasound,while 11,16 and 4 were classified of accreta, increta and perereta, respectively, by using CEUS based on the myometrial thickness and contrast agent subsided time. With respect to operation, 10 patients were confirmed of accrete,with the other diagnosed of increta and percreta. The misclassification rate of 2- dimensional color Doppler ultrasound was 19.6%, while CEUS had only 6.5 %. CEUS had a good agreement with operation (Kappa = 0. 859, P 〈 0. 001 ). Conclusions CEUS has higher accuracy in diagnosing subtypes of postpartum placenta accrete compared with 2-dimensional color Doppler ultrasound. CEUS can increase the accuracy and reliability for diagnosing those who were clinically considered of postpartum placenta accrete,and can provide helpful guidelines for clinical treatment.
出处 《中华超声影像学杂志》 CSCD 北大核心 2013年第4期337-339,共3页 Chinese Journal of Ultrasonography
关键词 超声检查 微气泡 胎盘 侵入性 Ultrasonography Microbubbles Placenta accreta
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参考文献8

  • 1陈欣林,赵胜,卢丹,杨小红,张磊,胡蕾,周明英.超声造影诊断胎盘植入的应用价值[J].中华超声影像学杂志,2009,18(6):521-524. 被引量:17
  • 2Ginny LR, Timothy JQ, Craig HS, et al. Placenta accreta postpartum. Am Coll Obstet Gynecol,2002, 100 : 1069-1072.
  • 3Hung TH, Shau WY, Hsieh CC, et aL Risk factors for placenta aecreta. Obstet Gyneeol, 1999,93 : 545-550.
  • 4Gielchinsky Y, Rojansky N, Fasouliotis SJ, et al. Placenta accreta- summary of 10 years: a survey of 310 cases. Placenta, 2002,23 : 210-214.
  • 5戴钟英.侵入性胎盘的命名、发生率及病因[J].实用妇产科杂志,2008,24(12):705-707. 被引量:56
  • 6Zalel Y, Cohen SB, Oren M, et al. Sonohysterography for the diagnosis of residual trophoblastie tissue. J Ultrasound Med, 2001,20 : 877-881.
  • 7Shih JC, Palacios Jaraquemada JM, Su YN, et al. Role of three- dimensional power Doppler in the antenatal diagnosis of placenta accreta: comparison with gray-scale and color Doppler techniques. Ultrasound Obstet Gynecol,2009,33 193-203.
  • 8Wong HS, Cheung YK, Zuccollo J. Evaluation of sonographic diagnostic criteria for placenta accreta. J Clin Ultrasound, 2008, 36..551-559.

二级参考文献19

  • 1周莉,吴连方.40例植入性胎盘的回顾性分析[J].首都医科大学学报,2005,26(1):90-92. 被引量:47
  • 2王辉,张建华,吴味辛.植入性胎盘23例临床分析[J].实用妇产科杂志,2005,21(2):93-95. 被引量:65
  • 3应豪,阮晟鸣,王德芬.胎盘植入的诊治进展[J].实用妇产科杂志,2007,23(6):335-336. 被引量:243
  • 4Bretelle F, Courbiere B, Mazouni C, et al. Management of placenta accrete: morbidity and outcome [ J]. Eurp J Obstet Gynecol, 2007,133(1) : 34- 39.
  • 5Gielchinsky Y, Rojansky N, Fasottliotis SJ, et al.Placenta accrete- summary of 10 years:a survey of 310 cases [J].Placen, 2002,28(2):210- 214.
  • 6Sumigama S, hakura A, Ota T, et al.Placenta previa increta/percreta in Japan: aretrospective study of ultrasound findings, management and clinical course [J] .J Obstet Gynecol Res ,2007,33(5) :606 - 611.
  • 7CunninghamFG,MacDonaldFC,GantNF.威廉姆斯产科学.郎景和,主译.第20版.西安:世界图书出版公司,1999:800-804.
  • 8Gielchinsky Y, Rojansky N, Fasouliotis SJ, et al. Placenta accretasummary of 10 year:a survey ot 310 cases. Placenta,2002,23:210- 241.
  • 9You WB, Zahn CM. Postpartum hemorrhage: abnormally adherent placenta, uterine inversion, and puerperal hematomas. Clin Obstet Gynecol, 2006,49 : 184 197.
  • 10Jauniaux E, Toplis PJ, Nicolaides KH. Sonographic diagnosis of a non-praevia placenta aecrete. Ultrasound Obstet Gynecol, 1996,7 : 58-60.

共引文献71

同被引文献112

  • 1郑琼,李胜利.胎盘植入产前诊断新进展[J].中华医学超声杂志(电子版),2013,10(7):538-541. 被引量:43
  • 2王辉,张建华,吴味辛.植入性胎盘23例临床分析[J].实用妇产科杂志,2005,21(2):93-95. 被引量:65
  • 3应豪,阮晟鸣,王德芬.胎盘植入的诊治进展[J].实用妇产科杂志,2007,23(6):335-336. 被引量:243
  • 4严英榴,杨秀雄.产前超声诊断学[M].2版.北京:人民卫生出版社,2012:394.
  • 5向宇,孙剑,齐宪荣.Basic physical, acoustic properties, and in vitro ultrasound imaging enhancement of the lipid-coated microbubbles[J].Journal of Chinese Pharmaceutical Sciences,2007,16(3):176-182. 被引量:1
  • 6ORDEN M R, LEINONEN M, KIRKINEN P. Contrast - en- hanced uhrasonography of uteroplacental circulation does not evoke harmful CTG changes or perinatal events [ J ]. Fetal Diagn Ther, 2000, 15(3) : 139 -145.
  • 7DENBOW M L, WELSH A W, TAYLOR M J. Twin Fetuses In- travascular microbubble US contrast agent administration early ex- pefience[J]. Radiology, 2000, 214(3) : 724 -728.
  • 8HAMED H O, SHAH1N A Y, ELSAMMAN A M. Itysterosalpingo - contrast sonography versus radiographic hysterosalpingography in the evaluation of tubal patency [ J ]. Int J Gynecol Obstet, 2009, 105(3) : 215 -217.
  • 9LOVSIN B, TOMAZEVIC T. Hysterosalpingo- contrast sonogra- phy for infertility investigation[ J]. Int J Gynaecol Obstet, 2010, 108(1):70-71.
  • 10Esakoff TF, Sparks TN, Kaimal AJ, et al. Diagnosis and morbidity ofplacenta accreta[J]. Ultrasound Obstet Gynecol, 2011, 37(3): 324-327.

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