| 摘要: |
| 目的 探讨超微血流成像（SMI）技术联合常规超声检查在产前胎盘植入诊断中的应用价值。 方法 选取2016年9月至2018年8月于我院行产前超声检查的孕妇，均行常规超声检查及SMI检查，诊断为胎盘植入患者59例及随机选取经分娩后临床诊断无胎盘植入患者60例，观察植入胎盘与病变肌层边界情况、胎盘附着处肌层厚度、胎盘内绒毛部与绒毛间隙间的血管情况及胎盘附着处子宫肌层与浆膜层连续性情况，采用受试者的工作特征（ROC）曲线分析观察指标对胎盘植入的诊断价值。并以术中诊断及术后病理诊断结果为金标准，对比评价分析常规超声检查与常规超声联合SMI检查对子宫胎盘植入诊断的应用价值。 结果 胎盘植入组与非胎盘植入组对比，胎盘植入组患者的胎盘与周边肌层界限不清或呈毛刺或锯齿样改变、胎盘附着处肌层菲薄或消失、胎盘内绒毛部与绒毛间隙间的血流丰富且血管交错的阳性率高于正常对照组，差异有统计学意义（Ｐ＜ 0.01）。上述指标行ROC曲线分析，综合诊断胎盘植入的曲线下面积为0.936，诊断准确性较高。产前常规超声检查诊断子宫胎盘植入的准确度、灵敏度及特异度分别为79.83%、78.00%和81.67%。SMI检查联合常规超声诊断子宫胎盘植入的准确度、灵敏度与特异度分别为89.92%、89.83%和90.00%。 结论 SMI检查能真实显示胎盘植入部位的低速血流情况，联合常规超声能较准确的评估胎盘植入的范围和程度，对胎盘植入的及时诊断有重要的临床价值。 |
| 关键词: 胎盘植入 超微血流成像技术 ROC曲线 |
| DOI： |
| 投稿时间：2019-03-11修订日期：2019-03-11 |
| 基金项目: |
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| Superb Micro Vascular Imaging (SMI) Combined Conventional Ultrasonic Application Value in prenatal diagnosis of placenta accrete |
| wuling,liqing |
| () |
| Abstract: |
| Objective: To assess Superb micro vascular imaging (SMI) combined conventional ultrasonic application Value in diagnosing prenatal placenta accreta. Methods: A total of 59 patients with placenta accreta from 2016 September to 2018 August examined by routine ultrasound examination and SMI were retrospectively analyzed. And sixty patients without placental implantation clinically diagnosed after delivery were randomly selected. The boundary of the intrauterine lesions, the thickness of the myometrium, the blood vessels of the placenta implantation site were observed. To evaluate the value of these indexes in diagnosing prenatal placenta accreta.by receiver operating characteristic(ROC) curves. In addition, using the intra-operative diagnosis and the postoperative pathological results as the golden standard to compare, evaluate and analyze application value of the conventional ultrasound examination and the conventional ultrasound examination combined with SMI examination in diagnosis of uterine placenta implantation. Results: The placental implantation group was compared with the non-placental implantation group, the incidence rate of the unclear boundary of the myometrium, the myometrium becoming thinner or disappeared, the interlace and disorder of blood vessels of the placenta implantation site increased significantly in the pregnant women with placenta implantation, there were statistically significant differences(P＜0.01). The value of area under the curve of the aggregative diagnosis in placental implantation was 0.936 according to the operating characteristic curves. The accuracy, sensitivity and specificity rating of prenatal routine ultrasound diagnosis in uterine placenta implantation was79.83%、78.00%、81.67% respectively. And, these respective ratings of the conventional ultrasound examination combined with SMI examination were 89.92%、89.83%、90.00%. Conclusion: SMI can reflect the lower velocity blood flow in placenta accurately. The extent and the range of the placenta implantation can be evaluated combining conventional ultrasound. It has the important clinical value in diagnosing prenatal placenta accrete timely. |
| Key words: Placenta accrete, Superb micro vascular imaging, Receiver operating characteristic(ROC) curves |
