超声测定子宫弓状动脉收缩期峰值流速 阻力指数 搏动指数对前置胎盘伴植入的诊断价值

Diagnostic value of ultrasound determination of PSVRI and PI in uterine arch artery with placenta previa with implantation

目的探究超声测定子宫弓状动脉收缩期峰值流速(PSV)、阻力指数(RI)、搏动指数(PI)对前置胎盘伴植入的诊断价值。方法将2016年7月至2019年5月我院收治的晚孕期前置胎盘孕妇58例纳为研究对象,以分娩时胎盘诊断结果分组,38例前置胎盘伴植入产妇纳入前置胎盘伴植入组,20例前置胎盘孕妇纳入前置胎盘组。2组产妇均进行腹部超声测定子宫弓状动脉PSV、RI、PI指标,对比2组检测结果,并对结果进行ROC曲线分析其诊断价值。结果前置胎盘伴植入组孕妇PSV、RI、PI指标均高于前置胎盘组,差异具有统计学意义(P<0.05);PSV诊断前置胎盘伴植入的曲线下面积为0.864,最佳截断值为36.36 cm/s时,可以获得最佳诊断效能,对应的特异度、灵敏度分别为0.974、0.600,约登指数为0.574,诊断价值相对理想。RI、PI指标AUC、敏感度、特异度相对较小,诊断价值相比较低。结论超声测定子宫弓状动脉PSV对前置胎盘伴植入的诊断价值较大,可以作为临床诊断前置胎盘伴植入的参考依据。

Objective To investigate the diagnostic value of ultrasonic measurement of peak systolic flow velocity(PSV), resistance index(RI), and pulsatility index(PI) of uterine arcuate artery for placenta previa with implantation. Methods A total of 58 pregnant women with placenta previa who were treated in our hospital from July 2016 to May 2019 were included in the study. Based on the diagnosis of placenta during delivery, 38 cases of placenta previa with implantation were included in placenta previa in the implantation group, 20 pregnant women with placenta previa were included in the placenta previa group. Both groups of mothers performed abdominal ultrasound to measure the PSV, RI, and PI indexes of the uterine arch artery, compared the results of the two groups, and analyzed the diagnostic value of the results by ROC curve. Results The values of PSV, RI and PI in pregnant women with placenta previa and implantation group were higher than those in the placenta previa group, and the differences were statistically significant(P<0.05). The result exceeded 0.7. When the optimal cutoff value was 36.36 cm/s, the best diagnostic performance could be obtained. The corresponding specificity and sensitivity were 0.974 and 0.600,respectively, and the Jordan index was 0.574. The diagnostic value was relatively ideal. RI, PI index AUC, sensitivity, specificity are relatively small, and the diagnostic value was relatively low. Conclusion Ultrasound measurement of PSV in uterine arcuate artery is of great diagnostic value for placenta previa with implantation.