【摘要】 目的探讨三维超声在产前胎盘植入诊断中的应用效果。方法以2014年3月—2018年12月经我院超声科产前筛查时疑似为胎盘植入并于我院分娩的40例病例作为研究对象,以产后病理结果为金标准,对产前三维超声检查的诊断价值进行分析,并比较三维超声和MRI在诊断胎盘植入的差异性。结果本研究40例疑似胎盘植入病例中,三维超声提示单纯前置胎盘19例,伴有PI 21例;MRI诊断单纯前置胎盘20例,伴有PI 20例。术后病理结果显示,单纯前置胎盘17例,PI 23例。超声诊断PI灵敏度为82.61%,特异度为88.24%,Youden指数70.84%。MRI诊断PI灵敏度为78.26%,特异度为88.24%,Youden指数66.50%。两种诊断方法准确率差异无统计学意义(χ~2=0.092,P=0.762);在植入型PI诊断方面三维超声明显优于MRI(P <0.05)。结论三维超声断层显像技术在诊断产前胎盘置入方面具有与MRI同样的临床价值,在不同分型胎盘植入诊断方面准确性更高。更多还原

【Abstract】 Objective To investigate the application effect of threedimensional ultrasound in the diagnosis of prenatal placenta implantation. Methods 40 cases of patients who were suspected to be placenta implantation and gave birth in our hospital during the prenatal screening in the ultrasound department of our hospital from March 2014 to December 2018 were selected as the research objects. The postpartum pathological results were taken as the gold standard to analyze the diagnostic value of prenatal 3 D ultrasound examination and compare the difference between 3 D ultrasound and MRI in the diagnosis of placenta implantation. Results There were 19 cases with simple placenta previa and 21 cases with PI indicated by three-dimensional ultrasound among the 40 cases in this study. MRI diagnosis showed there were 20 cases placenta previa alone, and 20 cases accompanied by PI.Postoperative pathological results showed that there were 17 cases of placenta previa alone and 23 cases of PI. The sensitivity, specificity and Youden index of ultrasonic diagnosis were 82.61%, 88.24% and 70.84% respectively. The sensitivity of MRI diagnostic in PI was 78.26%, specificity was 88.24%, and Youden index was 66.50%. There was no significant difference in accuracy between the two diagnostic methods(χ~2=0.092, P=0.762). Three-dimensional ultrasound was significantly superior to MRI in the diagnosis of implantable PI(P < 0.05). Conclusion Three-dimensional ultrasound tomography had the same clinical value as MRI in the diagnosis of prenatal placenta implantation, and it was more accurate in the diagnosis of different types of placenta implantation.更多还原