经阴道二维联合三维声学造影诊断产后胎盘植入

摘要

Objective To investigate the diagnostic value of combination transvaginal two dimensional and threedimensional contrast-enhanced ultrasonography(2D and 3D-CEUS)in the diagnosis of placenta remnants after postpartum.Methods This study from in Zhangzhou Hospital affiliated to the Fujian Medical University in 189 patients with suspected postpartum placenta (appendage residual) patients had received 2D and 3D-CEUS examination simultaneously,At the same time,the differences of using 2D combine with 3D-CEUS and using 2D-US lonely were compared.Results According to the pathological diagnosis,147 cases is residual placenta and 42 cases is placenta implantation.The diagnostic performance of using 2D combine with 3D-CEUS were 92.9％,98.6％,95.1％,98.0％ and 97.4％ and all better than using 2D-US lonely with which significant difference were discovered (P＜0.05).Conclusions 2D combine with 3D-CEUS is a more sensitive and specific tool for distinguishing residual placenta.%目的 探讨经阴道二维(2D-CEUS)联合三维声学造影(3D-CEUS)诊断产后胎盘植入的应用价值.方法 选取我院189例产后胎盘(附属物)残留的患者作为研究对象,于经阴道二维超声(2D-US)检查后行经阴道二维联合三维超声造影检查,观察病灶的位置、范围、边界、造影剂灌注特点,比较两者的诊断效能,分析病灶二维及三维超声造影声像图特征.结果 189例患者中胎盘植入42例,单纯胎盘残留147例,经阴道2D-US及经阴道2D-CEUS联合3D-CEUS诊断胎盘植入的灵敏度、特异度、阳性预测值、阴性预测值、准确性分别为80.1％ vs 92.9％、85.3％ vs 98.6％、80.1％ vs95.1％、89.3％vs 98.0％、86.1％ vs 97.4％,经阴道2D-CEUS联合3D-CEUS的各项诊断效能均高于单独使用经阴道2D-US(P值均＜0.05).结论 经阴道2D-CEUS联合3D-CEUS各项诊断效能均高于经阴道2D-US,可准确地反映残留胎盘的具体附着部位及活性表现,从而有效地诊断产后胎盘植入.