三维/四维煊流立体成像技术对前置胎盘并胎盘植入诊断的探讨

Application of Three/Four Dimensional HDlive Flow in the Diagnosis of Placenta Previa with Placenta Implantation

目的探讨三维/四维(three/four–Dimensional,3D/4D)煊流立体成像技术(HDlive Flow)对胎盘植入的诊断效能。方法收集109例来我院就诊并分娩的前置胎盘患者作为研究对象,均进行MRI检查(1.5 T)和3D/4D HDlive Flow诊断,将两次所得诊断结果与“金标准”(临床和/或病理诊断)进行比较。结果本组病例MRI正确诊断胎盘植入15例,漏诊7例,误诊4例;3D/4D诊断胎盘植入18例,漏诊4例,误诊2例。3D/4D在胎盘植入的诊断中,各项指标(特别是敏感性)都要优于MRI。与金标准相较,3D/4D在胎盘植入的诊断中除了准确性以外,其他指标均无统计学意义。结论4D HDlive Flow可实时观察可疑区域的血供情况,对病变部位血管走行及血流丰富程度做出更清晰、更准确的判断,可提高胎盘植入诊断的准确性,对临床治疗方案、预后评估等具有重要意义。

Objective To investigate the diagnostic efficacy of three/four-dimensional(three/four-dimensional,3D/4D)imaging technology(HDlive Flow)for placental accreta.Methods A total of 109 patients with placenta previa who came to our hospital for treatment and gave birth were collected as the research objects.They were all diagnosed by MRI(1.5 T)and 3D/4D HDlive Flow.The diagnosis results obtained twice were compared with the“gold standard”(Clinical and/or pathological diagnosis).Results In this group of cases,15 cases were correctly diagnosed with MRI,7 cases were missed,4 cases were misdiagnosed;18 cases of placenta accreta were diagnosed with 3D/4D diagnosis,4 cases were missed,and 2 cases were misdiagnosed.In the diagnosis of placental accreta,3D/4D had better indicators(especially sensitivity)than MRI.Compared with the gold standard,3D/4D had no statistical significance except for accuracy in the diagnosis of placental accreta.Conclusion 4D HDlive Flow can observe the blood supply of the suspicious area in real time,make clearer and more accurate judgments on the blood vessel course and the richness of blood flow in the diseased area,which can improve the accuracy of the diagnosis of placenta accreta,and is of great significance for clinical treatment plans and prognosis evaluation.