三维能量多普勒超声定量评估正常胎盘血流灌注和胎盘植入

Three-dimensional power Doppler ultrasonic quantitative assessment of placental perfusion in normal pregnancies and placenta accreta

目的采用三维能量多普勒超声（3D-PDU）观察正常前壁胎盘血流灌注情况,并对胎盘植入进行产前评估。方法将232名11~40孕周孕妇的正常单胎妊娠前壁胎盘作为正常对照组,10例经手术或病理证实为胎盘植入孕妇的胎盘作为观察组。采用3D-PDU的三维血管模式（3D Angio）,测量两组血管化指数（VI）、血流指数（FI）、血管化-血流指数（VFI）。分析正常对照组胎盘血流参数与孕龄的关系,并对比两组测量参数的差异。结果正常对照组胎盘VI、FI、VFI与孕龄相关（r=0.678、0.766、0.410,P均〈0.01）,且VFI与VI相关（r=0.800,P〈0.01）。观察组与正常对照组胎盘3D-PDU血流参数（VI、FI、VFI）差异均有统计学意义（P均〈0.05）。结论 3D-PDU可定量分析正常前壁胎盘血流灌注情况,为产前诊断胎盘植入提供量化评估依据。

Objective To observe normal placental perfusion, and assess the placenta accreta with three-dimensional pow- er Doppler ultrasound （3D-PDU）. Methods Totally 232 pregnant woman with healthy single fetal with gestational age （GA） and normal placentas between 11 to 40 weeks as normal group, and 10 cases of placenta accreta as abnormal group were enrolled. The vasularization index （VI）, flow index （FI） and vascularization-flow index （VFI） were measured using 3D-PDU. The relationships between normal placenta flow indices and GA, placenta flow parameters of placenta accrete and normal group were assessed. Results Normal placenta flow parameters （VI, FI, VFI） were statistically correlated with GA （r=0. 678, 0. 766, 0. 410, all P〈0. 01）. VFI and VI had a significant relationship （r=0. 800, P〈0.01）. There were statistically significant difference of placental flow parameters （VI, FI, VFI） between both groups （all P〈0.05）. Conclu- sion 3D-PDU can quantitatively analyze the perfusion in normal placenta, which provides a basis for quantitative assess- ment of placenta accreta in prenatal diagnosis.