摘要
目的分析彩色多普勒超声联合磁共振成像(MRI)诊断凶险型胎盘植入的临床价值。方法选取我院2014年2月至2019年12月期间收治的疑似凶险型胎盘置入患者113例,分别行彩色多普勒超声(彩超)、MRI检查,分析彩超、MRI及联合检查的诊断结果、漏诊率及误诊率,同时对比各检查结果的诊断灵敏度、特异度及准确度,同时对比凶险型胎盘植入患者、非胎盘植入者病灶及基底宫壁肌层血流动力学参数情况。结果113例患者经手术病理确证为凶险型胎盘植入80例,非胎盘植入者33例,彩超、MRI及联合检查中均存在“假阳”、“假阴”诊断结果;联合检查漏诊率3.8%,误诊率3.0%,分别低于MRI的3.8%、18.2%及彩超的20.0%、21.2%,差异有统计学意义(P<0.05);彩超+MRI联合检查的诊断敏感度为96.2%,特异度为97.0%,准确度为96.5%,高于MRI的86.2%、81.8%、85.0%,且高于彩超的80.0%、78.8%、79.6%,差异明显(P<0.05);凶险型胎盘植入患者血流速度最大值(Vmax)、血流速度最小值(Vmin)高于非胎盘植入者,S/D、阻力指数(RI)低于非胎盘植入者,差异明显(P<0.05)。结论彩色多普勒超声联合MRI用于凶险型胎盘植入的诊断效能高,可降低漏诊及误诊率。
Objective To analyze the clinical value of color Doppler ultrasound combined with magnetic resonance imaging(MRI)in diagnosing dangerous placenta accreta.Methods One hundred and thirty patients with suspected dangerous placental implantation admitted to our hospital from February 2014 to December 2019 were selected and received color Doppler ultrasound and MRI respectively.The diagnosis results,missed diagnosis rate and missed diagnosis rate of color Doppler ultrasound,MRI and combined examination were analyzed.Misdiagnosis rate,while comparing the diagnostic sensitivity,specificity and accuracy of each examination result,and comparing the hemodynamic parameters of dangerous placental implant patients,non-placental implant lesions and basal uterine muscular layer.Results One hundred and thirty patients were confirmed as dangerous placenta accreta by operation and pathology,and 33 cases were non-placental accreta.The diagnosis results of"false positive"and"false negative"were found in color Doppler ultrasound,MRI and combined examination;the missed diagnosis rate of combined examination was 3.8%,the misdiagnosis rate was 3.0%,which was lower than 3.8%and 18.2%of MRI and 20.0%and 21.2%of color Doppler ultrasound respectively.The difference was significant(P<0.05);the diagnostic sensitivity of combined color Doppler ultrasound and MRI was 96.2%and the specificity was 97.0%,accuracy is 96.5%,higher than 86.2%,81.8%,85.0%of MRI,and higher than 80.0%,78.8%,79.6%of color Doppler ultrasound,the difference is obvious(P<0.05);dangerous placental implants suffer from Vmax,Vmin was higher than those with non-placental accreta,S/D and RI were lower than those with non-placental accreta,the difference was significant(P<0.05).Conclusion Color Doppler ultrasound combined with MRI has high diagnostic efficiency for dangerous placental implants,which can reduce the missed diagnosis and misdiagnosis rate.
作者
刘淼
Liu Miao(Department of Ultrasound,Maternal and Child Health Hospital of Wolong District in Nanyang City,Henan 473000,China)
出处
《山西医药杂志》
CAS
2021年第10期1599-1602,共4页
Shanxi Medical Journal
基金
河南省教育厅科技项目(16B320007)。
关键词
超声检查
多普勒
彩色
磁共振成像
胎盘
侵入性
漏诊
误诊
准确度
Ultrasonography,doppler,color
Magnetic resonance imaging
Placenta,accreta
Missed diagnosis
Misdiagnosis
Accuracy
