探讨应用超声诊断胎盘植入的临床价值
Exploring the clinical value of ultrasound in diagnosing of Placenta accrete
齐海艳 1陈婷 2侯瑞 1刘月洁 1高俊雪1
作者信息
- 1. 厦门大学附属翔安医院超声科,福建厦门 361100
- 2. 厦门市第五医院超声科,福建厦门 361100
- 折叠
摘要
目的 探讨应用超声诊断胎盘植入的超声表现及临床价值.方法 回顾分析42例最终临床病理诊断子宫瘢痕处胎盘植入的超声表现.结果 42例子宫瘢痕均为剖宫产术后瘢痕,其胎盘植入的超声表现主要为3种类型:Ⅰ型计8例(19％),表现为胎盘后间隙显示不清,被胎盘组织占据,蜕膜强回声线显示不清,胎盘植入处子宫肌层变薄,厚度＜1 mm;Ⅱ型计23例(55％),在Ⅰ型基础上表现为子宫肌层消失,胎盘内见多发大小不等无回声延续至胎盘后及原子宫肌层区,呈陷窝及虫蚀样改变,无回声内呈高速湍流血流频谱,与子宫肌层区扩张血管相互连通分界不清;Ⅲ型计11例(26％),在Ⅱ型表现的基础上,胎盘置入处子宫浆膜层中断消失,膀胱后壁粗糙不平,光滑强回声线显示不清,可见多发桥接样血管,血流信号丰富.其中3例于植入处呈肿块样隆起突向膀胱.结论 剖宫产瘢痕处胎盘植入的超声表现有比较典型的超声特征,对胎盘植入区超声图像特征的识别利于胎盘植入的产前诊断.胎盘植入的分型诊断利于临床治疗方案的选择.
Abstract
Objective To investigate the ultrasound performance of placenta accrete.Methods The ultrasonographic features of placenta accrete in 42 patients with uterine scar diagnosed by clinicopathology were analyzed retrospectively.Results 42 Palace scars were all scars after cesarean section,and the ultrasound manifestations of placenta accrete were mainly three types:type Ⅰ:8 cases(19％),Prespresented by unclear retroplacental space,Occupiby placental tissue,The strong echo lines of the decidua show an indistinct,The myometrium thinning at the placenta accrete,Thickness is＜1mm;Type Ⅱ:23 cases(55％),Based on type Ⅰ,manifested by loss of myometrium,In the placenta,extending to the posterior placenta and the atomic myometrium area,Canest and insect erosion changes,High-speed turbulent blood flow spectrum within the anechoic,The connection between the dilated blood vessels and the myometrium area is unclear;Type Ⅲ:11 cases(26％),On the basis of the type Ⅱ of performance,Disruption of the uterine serosal layer disappeared at the placenta insertion site,The posterior wall of the bladder is rough and uneven,Smooth strong echo lines show un-clear,Multiple bridging sample blood vessels are visible,Blood flow signals are abundant.Three of them showed a mass-like bulge protruding into the bladder at the implant.Conclusion The ultrasound performance of placenta accrete at ce-sarean section scar has relatively typical ultrasound characteristics,and the identification of ultrasound image character-istics of placenta accrete area is conducive to the prenatal diagnosis of placenta accrete.Typing diagnosis of placenta ac-crete is beneficial to clinical treatment.
关键词
胎盘植入/超声诊断/瘢痕Key words
placenta accrete/ultrasonic diagnosis/scars引用本文复制引用
出版年
2024
NETL
NSTL
万方数据