三维能量多普勒超声对瘢痕子宫合并前置胎盘植入诊断价值分析.docVIP

三维能量多普勒超声对瘢痕子宫合并前置胎盘植入的诊断价值分析 　　[摘要]目的 评价三维能量多普勒超声（3D-PDU）在瘢痕子宫合并前置胎盘植入诊断中的价值。 方法 选取2011年2月～2015年12月在我院就诊的瘢痕子宫妊娠合并前置胎盘患者55例，均于产前进行二维彩色多普勒超声（2DCDPI）和3D-PDU诊断，以产后病理学检查结果为金标准，评价两种方法诊断准确率。 结果 病理结果显示，55例患者中胎盘植入者28例；2DCDPI正确检出20例，检出率71.43%，3D-PDU 正确检出27例，检出率96.43%，两组之间比较，差异有统计学意义（P0.05）；3D-PDU的敏感性、特异性、阳性预测值、阴性预测值以及准确性分别为96.43%、96.30%、96.43%、96.30%和96.36%，均显著高于2DCDPI（P0.05）。 结论 3D-PDU可从多方面、多角度显示胎盘和宫壁之间的异常血管重建，提高对瘢痕子宫合并前置胎盘植入的诊断准确率。 　　[关键词]三维能量多普勒超声；瘢痕子宫；前置胎盘植入；诊断价值 　　[中图分类号] R445.1 [文献标识码] B [文章编号] 2095-0616（2016）09-168-03 　　[Abstract] Objective To evaluate the diagnostic value of threedimensional power Doppler ultrasound （3D-PDU） in scar uterus complicated with placenta previa-accreta. Methods 55 patients with scar uterus complicated with placenta previa-accreta， who were in our hospital from February 2011 to December 2015， were selected and prenatal diagnosed by 2DCDPI and 3D-PDU. Postpartum pathological examination results were used as gold standard. The diagnostic accuracy of the two methods was evaluated. Results Pathological results showed that 28 cases of placenta accreta in 55 patients. 20 cases were detected correctly by 2DCDPI， and that detection rate was 71.43%. 27 cases were detected correctly by 3D-PDU， and that detection rate of 96.43%. There was significant difference in detection rate between the two groups （P0.05）.Sensitivity， specificity， positive predictive value， negative predictive value and accuracy of 3D-PDU were 96.43%， 96.30%， 96.43%， 96.30% and 96.36% respectively， all were significantly higher than those of 2DCDPI （P0.05）. Conclusion 3D-PDU can display abnormal vascular remodeling between the placenta and uterine wall in many ways and can improve the accuracy of the diagnosis of scar uterus combined with placenta previa-accreta. 　　[Key words] Three dimensional power Doppler ultrasound； Scar uterus； Placenta previa-accreta； Diagnostic value 　　瘢痕子宫是剖宫产术或肌壁肌瘤剥除术的主要并发症，愈合缓慢，若再次妊娠则可能引发子宫破裂、产后出血、前置胎盘、胎盘植入等不良后果，其中前置胎盘属常见并发症之一，是导致妊娠晚期出血的主要因素，也是造成胎