三维彩色能量成像对植入型凶险性前置胎盘的诊断价值

摘要

目的：探讨三维彩色能量成像(3D-CPA)在植入型凶险性前置胎盘(PPP)产前诊断中的价值。方法回顾分析我院诊断的34例植入型 PPP 的产前二维彩色多普勒超声(2D-CDFI)及3D-CPA 表现，并与产后病理结果进行对照，总结二者对 PPP 的灵敏度、特异度、阳性预测值及产前检出率。结果2D-CDFI诊断植入型PPP的灵敏度、特异度分别为76.4%、66.7%，阳性预测值为81.5%；3D-CPA诊断植入型PPP的灵敏度、特异度分别为91.1%、88.9%，阳性预测值达93.3%，差异有统计学意义(P <0.05)；3D-CPA 产前检出率90.4%(47/52)高于2D-CDFI检出率73.0%(38/52)，差异有统计学意义(P <0.05)。结论3D-CPA可从多方面多角度显示胎盘与宫壁之间的异常血管重建，提高植入型 PPP 的产前超声诊断率，在产前植入型PPP的诊断中具有重要临床价值。%Objective To investigate the value of three-dimensional color power angio(3D-CPA)in the prenatal diagnosis of pernicious placenta previa (PPP ) with placenta increta.Methods The ultrasonographic findings of PPP with placenta increta diagnosed in our hospital by 2D-CDFI and 3D-CPA were reviewed and compared with pathologic histology examination.For each of the two imaging methods, sensitivity,specificity,positive predictive value and prenatal diagnose accordance rate were summarized. Results For 3D-CPA,sensitivity,specificity and positive predictive value were 91.1%,88.9% and 93.3%, respectively.The results of 3D-CPA were higher than those in 2D-CDFI (sensitivity 76.4%,specificity 66.7%,positive predictive value 81.5% ),and were statistically significant (P <0.05 ).The diagnose accordance rate of 3D-CPA was statistically higher than that of 2D-CDFI (90.4% vs 73.0%;P <0.05). Conclusions 3D-CPA can display abnormal vascular reconstruction between the placenta and uterine wall from various angles,and is more accurate than 2D-CDFI.3D-CPA plays an important role in the prenatal diagnosis of PPP with placenta increta.