产前三维能量多普勒超声在胎盘植入中的诊断价值

Diagnostic value of prenatal three-dimensional power Doppler ultrasound in placental implantation

目的分析产前三维能量多普勒超声评价胎盘植入严重程度的效果。方法通过便利抽样法,选取2017年1月至2020年12月江西省妇幼保健院收治的100例前置胎盘合并胎盘植入产妇作为研究对象,按照胎盘植入严重程度分为重度组(胎盘附着在子宫下段瘢痕部位,32例)和轻中度组(胎盘未附着在子宫下段瘢痕部位,68例);另选取同时期胎盘位于前壁的100例正常产妇作为对照组。所有产妇均接受产前三维能量多普勒超声检查以及剖宫产手术,以术后病理结果作为金标准,比较三组产妇胎盘流量指数(FI)、血管流量指数(VFI)、感兴趣区峰值血流速度(PSV),分析FI、VFI、PSV对重度胎盘植入的诊断效能。结果重度组、轻中度组的FI、VFI及PSV高于对照组,重度组的FI、VFI及PSV高于轻中度组,差异有统计学意义(P<0.05)。VFI诊断重度胎盘植入的敏感度、特异度、约登指数以及曲线下面积(AUC)高于FI和PSV。结论三维能量多普勒超声是诊断胎盘植入的有效方式,在评价胎盘植入严重程度中具有较高应用价值,值得临床重视。

Objective To analyze the effect of prenatal three-dimensional power Doppler ultrasound in evaluating the severity of placental implantation.Methods Through the convenient sampling method,100 pregnant women with placenta previa and placenta accreta treated in Jiangxi Maternal and Child Health Hospital from January 2017 to December 2020 were selected as the research objects.According to the severity of placenta implantation,the patients were divided into severe group(placenta attached to lower uterine scar site,32 cases)and mild to moderate group(placenta not attached to lower uterine scar site,68 cases).Another 100 normal women with placenta in the anterior wall were selected as the control group.All maternal antenatal achieved three-dimensional power doppler ultrasound and cesarean section surgery and the postoperative pathological results as the gold standard.The placental flow index(FI),vascular flow index(VFI)and peak blood flow velocity(PSV)were compared among the three groups,and the diagnostic efficacy of FI,VFI and PSV for severe placental implantation was analyzed.Results FI,VFI and PSV of the severe group and mild-moderate group were higher than those of the control group,and FI,VFI and PSV of the severe group were higher than those of the mild-moderate group,and the differences were statistically significant(P<0.05).The sensitivity,specificity,Youden index and area under curve(AUC)of VFI in the diagnosis of severe placental implantation were higher than those of FI and PSV.Conclusion Three dimensional power Doppler ultrasound is an effective way to diagnose placental implantation.It has high application value in evaluating the severity of placental implantation and is worthy of clinical attention.