超声评分法联合三维能量多普勒血流灌注参数对胎盘植入性疾病的诊断价值

The Diagnostic Value of Ultrasound Scoring Combined with Three-dimensional Power Doppler Blood Flow Perfusion Parameters for Placental Implantation Diseases

袁红梅 ¹许聃 ²张丽 ¹孙广宏¹

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作者信息

1. 宁夏回族自治区人民医院,宁夏医科大学第三临床医学院,银川 750002
2. 银川市妇幼保健院,银川 750002
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摘要

目的探讨超声评分法联合三维能量多普勒超声(3D power doppler ultrasonography,3D-PDU)诊断胎盘植入性疾病(placenta accreta,PAS)不同病理分型的应用价值.方法分析112例疑似PAS的孕妇,术前进行超声评分,并进行3D-PDU检查,测量血管指数(vascularization index,VI)、血流指数(flow index,FI)和血管-血流指数(vascularization flow index,VFI).以病理诊断为金标准将样本分为不同组别,比较组间血流灌注参数的差异性.结果 112例疑似PAS患者病理证实92例,PAS组V1、FI及VF1均高于无PAS组(P均＜0.05).92例PAS中未侵入肌层即粘连型24例,侵入肌层包括植入型和穿透型68例,侵入肌层组的VI、FI及VFI均高于非侵入肌层组(P均＜0.05).而植入型与穿透型比较时,穿透型的VI、VF1均高于植入型(P均＜0.05).采用超声评分法联合3D-PDU诊断粘连型、植入型以及穿透型胎盘植入的Kappa值分别为0.724、0.856和0.892.结论超声评分法与3D-PDU联合使用可定量分析胎盘血流灌注情况,为产前诊断PAS的精准分型提供量化评估依据.

Abstract

Objective To explore the application value of ultrasound scoring combined with three-dimensional power Doppler ultrasonography(3D-PDU)blood flow perfusion parameters in diagnosing different pathological subtypes of placenta accteta spectrum(PAS).Methods 112 pregnant women suspected of PAS were analyzed.Ultrasound scores were performed before surgery,and 3D-PDU examination was performed to measure vascularization index(VI),flow index(FI),and vascularization flow index(VFI).Using pathological diagnosis as the gold standard for grouping,the differences in blood flow perfusion parameters between each group were compared.Results Among the 112 suspected PAS cases,92 were confirmed by pathology.Compared with the non PAS group,there were significant differences in VI,FI and VFI(P all＜0.05).Among the 92 cases of PAS confirmed by pathology,24 cases did not invade the muscular layer,which was adhesive type,and 68 cases invaded the muscular layer,including implanted and penetrating types.The VI,FI and VFI of the invasive muscle group were higher than those of the non-invasive muscle group(P all＜0.05).When comparing the implanted type with the penetrating type,there was a significant difference in VI and VFI(P all＜0.05).The Kappa values for diagnosing adherent,implanted,and penetrating placental implantation using ultrasound scoring combined with 3D-PDU were 0.724,0.856 and 0.892,respectively.Conclusion The combination of ultrasound scoring method and 3D-PUD can quantitatively analyze the placental blood flow perfusion,and provide quantitative evaluation basis for the accurate classification of prenatal testing diagnosis of placental implantable diseases.

关键词

胎盘植入性疾病/三维能量多普勒超声/超声评分法

Key words

placental implantation disease/three dimensional power Doppler ultrasonography/ultrasound scoring method

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基金项目

宁夏自然科学基金项目(2022AAC03392)

出版年

2024

宁夏医科大学学报

宁夏医科大学

宁夏医科大学学报

CSTPCD

影响因子：0.84

ISSN：1674-6309

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