帆状胎盘的产前超声诊断研究-影像医学与核医学专业论文.docxVIP

中文摘要 目的 探讨帆状胎盘的超声声像表现，提高产前超声诊断帆状胎盘的准确率。 方法 选择 2007年1 月到 2010 年 12 月在北京大学深圳医院超声科接受 III 级产前超 声筛查并诊断为帆状胎盘的病例 42 例，结合产后胎盘大体病理观察，回顾性分析其声像 图特征。 结果 本组病例中产前超声检查诊断帆状胎盘 42 例，产后病理证实帆状胎盘 34 例， 球拍状胎盘 8 例，符合率 81%（34/42）。总结帆状胎盘的超声表现除了脐带附着于胎膜外， 帆状附着前及附着后脐血管的走行有以下表现：（1）见多处单根脐动脉与单根脐静脉伴行 出入胎盘；（2）脐动脉进入胎盘前或脐静脉出胎盘后呈单根独立走行；（3）脐动脉进入胎 盘前先发出分支或脐静脉出胎盘后再汇合。 结论 脐带帆状附着前及附着后异常脐血管的走行可作为超声诊断帆状胎盘的可靠线 索，在提高产前超声诊断帆状胎盘的准确率方面有重要的临床价值。 关键词 脐带附着异常；帆状胎盘；产前诊断；超声 Abstract Objective ： The aim of this article is to evaluate and summarize the ultrasonographic appearances of velamentous placenta then improve the diagnosis accuracy of it. Methods：42 fetuses who were prenatally diagnosed as velamentous placenta by ultrasonography over the last 4 years in ultrasonography department of Peking University Shenzhen Hospital were retrospectively investigated for their sonographic features. Results ： 42 fetuses were diagnosed as velamentous placenta by prenatal ultrasonography. Postnatal gross appearance of placenta confirmed that 34 of them were velamentous placenta, 8 were battledore placenta. The accuracy rate is 81% (34/42).Accept the characteristic of umbilical cord attaching to amniotic membranes,the sonographic finding of velamentous placenta are as follow: (1) Single umbilical artery accompanying with single umbilical vein access to the placenta; (2) Umbilical artery that enter the placenta or umbilical vein that come out from the placenta runs independently; (3) Umbilical artery sends out the branches before entering the placenta. Conclusions：The distribution of aberrant umbilical vessels is a reliable clues to make the diagnosis of velamentous placenta and it has a great clinical value in improving the accuracy of prenatal ultrasonographic diagnosis of velamentous placenta. Key words: umbilical cord anomalies;Velamentous placenta;prenatal diagnosis; Ultrasonography 中英文名词对照表 脐带帆状附着 Velamentous cord insertion,VCI 帆状胎盘 Velamentous placenta 血管前置 Vasa previa 球拍状胎盘 Battledore placenta 双胎输血综合征 Twin-twin transfusi