三维彩色多普勒超声诊断在胎盘早剥诊断中的应用价值研究

Study on the application of 3D color Doppler ultrasound diagnosis in the diagnosis of placental abruption

目的:探讨三维彩色多普勒超声诊断在胎盘早剥诊断中的应用价值。方法:选取妇幼保健院收治的82例疑似胎盘早剥的孕妇资料,所有孕妇均接受产前三维彩色多普勒超声检查和产后胎盘病理检查,分析超声诊断的声像图特征、超声诊断与胎盘病理的一致性,比较超声诊断鉴别轻型和重型胎盘早剥的灵敏度。结果:在82例疑似胎盘早剥孕妇中,产后胎盘病理检查确诊44例,产前超声阳性检出与病理相符35例。误诊7例(占18.42%),漏诊9例(占20.45%)。超声诊断的灵敏度为79.55%,特异度为81.58%,阳性预测率为83.33%,阴性预测率为77.50%,准确率为80.49%。超声诊断与胎盘病理的一致性检验Kappa系数为0.609。轻型胎盘早剥26例,超声诊断灵敏度69.23%,重型胎盘早剥18例,超声诊断灵敏度94.44%。重型胎盘早剥的超声诊断灵敏度高于轻型,差异有统计学意义(x^2=4.156,P<0.05)。结论:三维彩色多普勒超声诊断胎盘早剥与胎盘病理检查一致性较好,可有效诊断胎盘早剥,其灵敏度较高。

Objective: To explore the application value of three-dimensional(3 D) color Doppler ultrasound diagnosis in the diagnosis of placental abruption. Methods: Data of 82 pregnant women with suspected placental abruption who admitted Maternal and Child Health Hospital were selected. All pregnant women underwent prenatal 3 D color Doppler ultrasonography and postpartum placental pathological examination. The sonographic characteristics of ultrasonic diagnosis, and the consistency between ultrasonic diagnosis and placental pathology were analyzed, and the sensitivity of ultrasonic diagnosis in distinguishing mild and severe type of placental abruption was compared. Results: In the 82 pregnant women with suspected placental abruption, 44 cases were confirmed by postpartum placental pathological examination. 35 positive cases that were detected by prenatal ultrasound were consistent with pathology. 7 cases(18.42%) were misdiagnosed and 9 cases(20.45%) were missed diagnosed. The sensitivity, specificity, positive predictive rate, negative predictive rate and accuracy of ultrasound diagnosis were 79.55%, 81.58%, 83.33%, 77.50% and 80.49%, respectively. The Kappa coefficient of consistency test between ultrasound diagnosis and placental pathology was 0.609. There were 26 cases with mild type of placental abruption, and the sensitivity of ultrasound diagnosis was 69.23%. There were 18 cases with severe type of placental abruption, and the sensitivity of ultrasound diagnosis was 94.44%. The sensitivity of ultrasound diagnosis of severe type of placental abruption was significantly higher than that of mild type of that(x^2=4.156, P<0.05). Conclusion: The consistency between 3 D color Doppler ultrasound diagnosis and placental pathological examination is better for diagnosing placental abruption. It can effectively diagnose placental abruption, and its sensitivity is higher.