高分辨彩色多普勒诊断胎盘植入的运用价值

Application value of high resolution color Doppler in diagnosis of placenta implantation

目的分析高分辨彩色多普勒诊断胎盘植入的运用价值。方法 110例低置胎盘或前置胎盘患者,均经腹部或阴道高分辨彩色多普勒超声对其进行扫查。比较超声及手术病理胎盘植入检出率,观察胎盘植入超声检查的特异度、敏感度、阴性及阳性预测值。结果 110例患者中经腹部或阴道超声检查确认45例疑似胎盘植入患者,但经手术病理检查确诊实际胎盘植入患者44例;超声检出率为40.91%(45/110),与手术病理检出的40.00%(44/110)比较,差异无统计学意义(P>0.05)。其中超声检出植入性胎盘29例,粘连性胎盘7例,穿透性胎盘4例,误诊5例,漏诊4例。高频彩色多普勒超声检测胎盘植入的特异度为92.42%(61/66)、敏感度为90.91%(40/44)、阴性预测值93.85%(61/65)、阳性预测值88.89%(40/45)。结论应用高分辨彩色多普勒超声诊断胎盘植入具有检出率良好、无创等优点,值得进一步在临床应用及推广。

Objective To analyze application value of high resolution color Doppler in diagnosis ofplacenta implantation.Methods A total of110patients with low-lying placenta or placenta previa receivedtransabdominal or transvaginal high resolution color Doppler ultrasound scanning.Comparison was made on detection rate of placenta implantation by ultrasound and surgery pathology.Observation was made on specificity,sensibility,negative predictive value and positive predictive value of ultrasound examination for placentaimplantation.Results Among110patients,there were45suspected placenta implantation cases shown bytransabdominal or transvaginal ultrasound examination,while surgery pathology examination showed44caseswith diagnosed placenta implantation.Detection rate by ultrasound was40.91%(45/110),and surgery pathologyhad detection ate as40.00%(44/110),and their difference had no statistical significance(P>0.05).Ultrasoundexamination showed29cases with placenta increta,7cases with adherent placenta,4cases with placenta percreta,5cases with misdiagnosis,and4cases with missed diagnosis.High resolution color Doppler ultrasound hadspecificity as92.42%(61/66),sensibility as90.91%(40/44),negative predictive value as93.85%(61/65)andpositive predictive value as88.89%(40/45).Conclusion Implement of high resolution color Doppler ultrasoundin diagnosing placenta implantation contains advantages of good detection rate and no trauma.This method isworth further clinical application and promotion.