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常规超声联合超声造影诊断胎盘植入的应用价值
Convention Ultrasound and Contrast-enhanced Ultrasound Imaging in the Diagnosis of Placenta Implantation
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摘要: 【摘要】 目的 探讨常规超声、超声造影以及两者联合诊断胎盘植入的应用价值。方法 收集2013年4月至2016年3月经手术病理诊断为胎盘残留的患者112例，根据病理诊断分为非植入组(n =38)和植入组(n =74)。比较两组常规超声、超声造影特征的区别，以多因素logistic回归建立判别式并比较三种方法预报胎盘残留是否伴有植入的准确性，比较三种方法ROC曲线的曲线下面积（AUC ）。结果 常规超声检查发现宫腔内病灶，发现病灶与周围子宫肌层的分界是否清楚在两组间差异有统计学意义（P <0.05）。超声造影的定性分析指标〔包括增强时相、增强强度、造影后病灶与子宫肌层分界是否清楚、边界是否规整、病灶附着处子宫肌层厚度较对侧子宫肌层是否变薄（简称较对侧子宫肌层是否变薄）〕在两组之间差异均有统计学意义（P <0.05）。超声造影（91.1%）以及联合诊断的logit（P ）判别式的预报准确性（92.0%）高于常规超声（87.5%），差异有统计学意义（P <0.05）。超声造影AUC（0.922）以及联合诊断（0.952）高于常规超声（0.887）（P <0.05），但超声造影和联合诊断之间的预报准确性和AUC差异均无统计学意义。结论 超声造影及联合诊断用于鉴别胎盘植入的价值均高于常规超声，有潜力成为胎盘残留的常规影像诊断方法。
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关键词:
- 超声造影 造影剂 胎盘残留 胎盘植入
Abstract: 【Abstract】 Objective To determine the value of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in the diagnosis of placenta residue with implantation. Methods We retrospectively analyzed 112 cases of placenta remnants from Apr. 2013 to Mar. 2016, all of which were confirmed by pathological results. The cases were divided into implanted (n =74) and non-implanted (n =38) groups. We compared the characteristics of US and CEUS imaging between the two groups. Multi-variate logistic regression models were established to assess the accuracy of ultrasound imaging in predicting implantation, including the area under the curve (AUC ) of receiver operating characteristic (ROC) curves. Results US detected intrauterine lesions, with significant differences between the two groups in the clearness of boundaries of lesions (P <0.05) . Differences between the two groups were also found in CEUS in enhanced phase, enhanced intensity, existence of clear and regular boundaries, and reduced muscle thickness in the lesion area (P <0.05). CEUS (91.1%) and US+CEUS (92.0%) had a higher prediction accuracy for placenta implantation compared with US (87.5%) (P <0.05). The AUC of CEUS (0.922) and US+CEUS (0.952) were also significantly higher than that of US (0.887) (P <0.05). No significant differences were observed between CEUS and US+CEUS. Conclusion The value of CEUS for predicting placenta implantation is higher than US. -
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期刊类型引用(14)
1. 谢平，金晓倩，张乾泉，黄正敏. 3D-PDU胎盘及子宫动脉血流动力学参数与胎盘植入的相关性分析. 中国现代医学杂志. 2023(17): 76-83 . 
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4. 陈晖，鲁红霞，贾颍辉. 经腹联合经阴道超声诊断子宫瘢痕处胎盘植入价值分析. 黑龙江医学. 2020(04): 540-542 . 百度学术
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12. 佘敏捷，何松. 分析联合应用高、低频超声诊断中晚孕期前壁胎盘植入的临床价值. 中外医疗. 2018(16): 172-174 . 百度学术
13. 廖建梅，杨舒萍，王霞丽，张伟娜，吕国荣. 经阴道二维联合三维声学造影诊断产后胎盘植入. 中国超声医学杂志. 2018(05): 442-445 . 百度学术
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