超声测量子宫弓状动脉血流参数在产前前置胎盘伴胎盘植入诊断中的价值

Value of ultrasound measurement of uterine arcuate artery blood flow parameters in the diagnosis of prenatal placenta previa complicated with placenta accreta

目的探讨超声测量子宫弓状动脉血流参数在产前前置胎盘伴胎盘植入诊断中的价值。方法选取60例接受检查的孕晚期前置胎盘孕妇作为研究对象,根据综合检查结果将其分为胎盘植入组(38例)和非植入组(22例)。孕妇均接受腹部超声检查,记录并比较各组孕妇的子宫弓状动脉血流参数、超声图像特征。以综合检查结果为金标准,分析子宫弓状动脉血流参数联合超声图像特征诊断产前前置胎盘伴胎盘植入的价值。结果胎盘植入组的子宫弓状动脉收缩期峰值血流速度(PSV)明显高于非植入组,阻力指数(RI)、搏动指数(PI)明显低于非植入组(P<0.05)。粘连组的PI明显高于植入组(P<0.05);粘连组和植入组的PSV明显低于穿透组,RI、PI明显高于穿透组(P<0.05)。胎盘植入组的胎盘陷窝、胎盘后间隙消失、胎盘后丰富血流信号占比均明显高于非植入组(P<0.05)。子宫弓状动脉血流参数联合超声图像特征诊断产前前置胎盘伴胎盘植入的灵敏度为94.74%,特异度为86.36%,准确度为91.67%。结论通过超声测量子宫弓状动脉血流参数诊断产前前置胎盘伴胎盘植入具有明确的价值,其可用于产前前置胎盘伴胎盘植入的辅助诊断。

Objective To investigate the value of ultrasound measurement of uterine arcuate artery blood flow parameters in the diagnosis of prenatal placenta previa complicated with placenta accreta.Methods A total of 60 pregnant women with placenta previa in late pregnancy who received examination were selected as the research objects.According to the comprehensive examination results,the pregnant women were divided into placenta accreta group(38 cases)and non-implanted group(22 cases).All pregnant women received abdominal ultrasound examination,and the uterine arcuate artery blood flow parameters and ultrasound image characteristics of pregnant women in each group were recorded and compared.Taking the comprehensive examination results as the gold standard,the value of uterine arcuate artery blood flow parameters combined with ultrasound image characteristics in the diagnosis of prenatal placenta previa complicated with placenta accreta was analyzed.Results The peak systolic velocity(PSV)of uterine arcuate artery in the placenta accreta group was significantly higher than that in the non-implanted group,while the resistive index(RI)and pulsatility index(PI)were significantly lower than those in the non-implanted group(P<0.05).The RI in the adhesion group was significantly higher than that in the implantation group(P<0.05);the PSV in the adhesion group and the implantation group was significantly lower than that in the penetration group,while the RI and PI were significantly higher than those in the penetration group(P<0.05).The percentage of placental lacunae,disappearance of retroplacental space and abundant postplacental blood flow signals in the placenta accreta group were significantly higher than those in the non-implanted group(P<0.05).The sensitivity,specificity and accuracy of uterine arcuate artery blood flow parameters combined with ultrasound image characteristics in the diagnosis of prenatal placenta previa complicated with placenta accreta were 94.74%,86.36%and 91.67%.Conclusion In clinical diagnosis of prenatal placenta previa complicated with placenta accreta,ultrasound measurement of uterine arcuate artery blood flow parameters has a clear diagnostic value,and it can be used for auxiliary diagnosis of prenatal placenta previa complicated with placenta accreta.