Objective: To evaluate the ultrasonographic charateristics and the diagnostic value in placental implantation abnormality (PIA) with transabdominal Doppler ultrasound, and improve the rate of diagnosis accuracy in the...Objective: To evaluate the ultrasonographic charateristics and the diagnostic value in placental implantation abnormality (PIA) with transabdominal Doppler ultrasound, and improve the rate of diagnosis accuracy in the prenatal and postnatal of PIA with transabdominal Doppler ultrasound, for early diagnosis and treatment, to avoid hysterectomy caused by fatal bleeding. Methods: There were 61 cases complicated with PIA by operation and pathologically confirmed in our hospital. 33 cases were prenatal PIA, and 28 cases were postnatal PIA. The sonographic characteristics of PIA were summarized, the sensitivity and false negative rate of transabdominal Doppler ultrasound were analyzed with the results of surgical and pathological diagnosis. Results: In the images of prenatal PIA, the incidence of abundant blood flow signals in muscular layer of the placenta was the highest, which could reached 85.7%, followed by placenta 'vortex' and placenta previa;placental remnants were major sonographic performance in postnatal PIA, the incidence rate was 100%, followed by abundant blood flow signals in muscular layer of the placenta and disappeared boundary between myometrium and placenta. 14 cases could be diagnosed as prenatal PIA accurately by transabdominal Doppler ultrasound, the sensitivity was 42.4%, and the false negative rate was 57.6%. 21 cases could be diagnosed as postnatal PIA accurately by transabdominal Doppler ultrasound, the sensitivity was 75.0%, and the false negative rate was 25.0%. Conclusions: The specificity was low in prenatal PIA by transabdominal Doppler ultrasound, but the false negative rate was high. If necessary, the diagnostic accuracy could be improved combined with MRI. The specificity was much higher in postnatal PIA, and the false negative rate was low. The ultrasonography of PIA has some certain characteristics, we should strengthen the consciousness of the diagnosis in PIA, especially in the prenatal PIA, and improve the auxiliary diagnosis.展开更多
The course and outcome is poor for most patients with pancreatic diseases.Advances in pancreatic imaging are important in the detection of pancreatic diseases at early stages.Ultrasonography as a diagnostic tool has m...The course and outcome is poor for most patients with pancreatic diseases.Advances in pancreatic imaging are important in the detection of pancreatic diseases at early stages.Ultrasonography as a diagnostic tool has made,virtually speaking a technical revolution in medical imaging in the new millennium.It has not only become the preferred method for first line imaging,but also,increasingly to clarify the interpretation of other imaging modalities to obtain efficient clinical decision.We review ultrasonography modalities,focusing on advanced pancreatic imaging and its potential to substantially improve diagnosis of pancreatic diseases at earlier stages.In the first section,we describe scanning techniques and examination protocols.Their consequences for image quality and the ability to obtain complete and detailed visualization of the pancreas are discussed.In the second section we outline ultrasonographic characteristics of pancreatic diseases with emphasis on chronic pancreatitis.Finally,new developments in ultrasonography of the pancreas such as contrast enhanced ultrasound and elastography are enlightened.展开更多
目的探讨床旁超声(腹部超声+会阴超声)检查预测足月分娩时机和方式的应用价值。方法回顾性分析2022年3月~2023年8月在佛山顺德爱博恩妇产医院建档产检并进行分娩的57例孕妇的临床资料,按实际分娩方式分为顺产组(n=48)和剖宫产组(n=9)。...目的探讨床旁超声(腹部超声+会阴超声)检查预测足月分娩时机和方式的应用价值。方法回顾性分析2022年3月~2023年8月在佛山顺德爱博恩妇产医院建档产检并进行分娩的57例孕妇的临床资料,按实际分娩方式分为顺产组(n=48)和剖宫产组(n=9)。所有孕妇在孕后期进行腹部超声+会阴超声检查,根据超声监测指标对分娩时机和方式进行预测和干预,并将预测结果与实际临产时间和分娩方式进行对比分析。结果主要监测指标单因素分析显示,两组差异无统计学意义(P>0.05);多因素Logistic回归分析表明,各监测指标对实际分娩方式无显著影响(P>0.05),各监测指标联合预测顺产的曲线下面积(Area under the curve,AUC)具有统计学意义(P=0.032<0.05);根据腹部超声+会阴超声检查结果预测分娩孕周均与实际分娩孕周相符,准确度为100%,预测分娩方式的准确度为91.38%,根据腹部超声+会阴超声预测结果进行干预的得当率为92.98%。结论床旁超声监测胎头下降距离、胎头-会阴距离、产程进展角和宫颈长度可以作为联合预测顺产的重要参考指标。各指标联合分析对临床预测分娩时机和选择分娩方式有指导作用,在预防产科紧急手术和控制分娩风险方面具有一定作用。展开更多
文摘Objective: To evaluate the ultrasonographic charateristics and the diagnostic value in placental implantation abnormality (PIA) with transabdominal Doppler ultrasound, and improve the rate of diagnosis accuracy in the prenatal and postnatal of PIA with transabdominal Doppler ultrasound, for early diagnosis and treatment, to avoid hysterectomy caused by fatal bleeding. Methods: There were 61 cases complicated with PIA by operation and pathologically confirmed in our hospital. 33 cases were prenatal PIA, and 28 cases were postnatal PIA. The sonographic characteristics of PIA were summarized, the sensitivity and false negative rate of transabdominal Doppler ultrasound were analyzed with the results of surgical and pathological diagnosis. Results: In the images of prenatal PIA, the incidence of abundant blood flow signals in muscular layer of the placenta was the highest, which could reached 85.7%, followed by placenta 'vortex' and placenta previa;placental remnants were major sonographic performance in postnatal PIA, the incidence rate was 100%, followed by abundant blood flow signals in muscular layer of the placenta and disappeared boundary between myometrium and placenta. 14 cases could be diagnosed as prenatal PIA accurately by transabdominal Doppler ultrasound, the sensitivity was 42.4%, and the false negative rate was 57.6%. 21 cases could be diagnosed as postnatal PIA accurately by transabdominal Doppler ultrasound, the sensitivity was 75.0%, and the false negative rate was 25.0%. Conclusions: The specificity was low in prenatal PIA by transabdominal Doppler ultrasound, but the false negative rate was high. If necessary, the diagnostic accuracy could be improved combined with MRI. The specificity was much higher in postnatal PIA, and the false negative rate was low. The ultrasonography of PIA has some certain characteristics, we should strengthen the consciousness of the diagnosis in PIA, especially in the prenatal PIA, and improve the auxiliary diagnosis.
文摘The course and outcome is poor for most patients with pancreatic diseases.Advances in pancreatic imaging are important in the detection of pancreatic diseases at early stages.Ultrasonography as a diagnostic tool has made,virtually speaking a technical revolution in medical imaging in the new millennium.It has not only become the preferred method for first line imaging,but also,increasingly to clarify the interpretation of other imaging modalities to obtain efficient clinical decision.We review ultrasonography modalities,focusing on advanced pancreatic imaging and its potential to substantially improve diagnosis of pancreatic diseases at earlier stages.In the first section,we describe scanning techniques and examination protocols.Their consequences for image quality and the ability to obtain complete and detailed visualization of the pancreas are discussed.In the second section we outline ultrasonographic characteristics of pancreatic diseases with emphasis on chronic pancreatitis.Finally,new developments in ultrasonography of the pancreas such as contrast enhanced ultrasound and elastography are enlightened.
文摘目的探讨床旁超声(腹部超声+会阴超声)检查预测足月分娩时机和方式的应用价值。方法回顾性分析2022年3月~2023年8月在佛山顺德爱博恩妇产医院建档产检并进行分娩的57例孕妇的临床资料,按实际分娩方式分为顺产组(n=48)和剖宫产组(n=9)。所有孕妇在孕后期进行腹部超声+会阴超声检查,根据超声监测指标对分娩时机和方式进行预测和干预,并将预测结果与实际临产时间和分娩方式进行对比分析。结果主要监测指标单因素分析显示,两组差异无统计学意义(P>0.05);多因素Logistic回归分析表明,各监测指标对实际分娩方式无显著影响(P>0.05),各监测指标联合预测顺产的曲线下面积(Area under the curve,AUC)具有统计学意义(P=0.032<0.05);根据腹部超声+会阴超声检查结果预测分娩孕周均与实际分娩孕周相符,准确度为100%,预测分娩方式的准确度为91.38%,根据腹部超声+会阴超声预测结果进行干预的得当率为92.98%。结论床旁超声监测胎头下降距离、胎头-会阴距离、产程进展角和宫颈长度可以作为联合预测顺产的重要参考指标。各指标联合分析对临床预测分娩时机和选择分娩方式有指导作用,在预防产科紧急手术和控制分娩风险方面具有一定作用。
