摘要
目的探讨超声造影对胎盘植入的诊断价值。方法27例临床疑似胎盘植入患者在常规超声检查后应用造影剂SonoVue进行超声造影检查，实时观察超声造影过程，分析造影剂灌注特点。结果3例孕妇中2例超声造影显示胎盘与肌层分界清，引产后无胎盘残留；1例孕妇超声造影提示局部胎盘与肌层分界消失，引产失败后剖宫取胎，术中见局部胎盘与宫壁粘连紧密，经钳夹胎盘基本清除。20例产后患者进行保守治疗，超声造影与清官术结果对比：5例超声造影显示宫腔残留病灶与子宫肌层分界清楚，15例宫腔残留病灶局部与肌层分界消失，肌层未见变薄。4例产后患者行子宫全切及次全切术，其超声造影与手术结果对比：超声造影显示残留胎盘局部与肌层分界消失、肌层变薄，浆膜完整，术中及病理均证实胎盘植入。结论超声造影显示胎盘与肌层分界消失，肌层变薄均提示有胎盘植入发生。
Objective To evaluate the value of contrast-enhanced ultrasound（CEUS） in diagnosis of placental increta. Methods Twenty seven suspected patients with placental increta were examined with CEUS after routine ultrasound examination. SonoVue was injected intravenously as bolus and a real time CEUS was performed. The characteristics of contrast perfusion was analysised. Results Among the three antepartum CEUS cases, two had a clear boundary between the placenta and uterine wall, there was no residual placenta after induced labor;one had a blur boundary between the local placenta and uterine wall, and the local placenta adherenced to the uterine wall tightly when cesarean section was performed after induction failure. Comparison between CEUS and uterine curettage in 20 cases,5 cases had a clear boundary between residual disease in uterine cavity and uterine wall. The boundary between residual disease in uterine cavity and uterine wall disappeared in other 15 cases. Four cases performed total and subtotal hysterectomy, the uterine myometrium of placenta affixing part were very thin （3 - 5 mm） ,and the boundary between the placenta and uterine wall disappeared, and placental increta was proved by intraoperative and pathology. Conclusions When the boundary between residual placenta and uterine wall disappeared and/or the local uterine wall became thin,placental increta was suggested intensively.
出处
《中华超声影像学杂志》
CSCD
北大核心
2012年第3期236-239,共4页
Chinese Journal of Ultrasonography
基金
基金项目：浙江省人口和计划生育科技项目
关键词
超声检查
微气泡
胎盘
胎盘
侵入性
Ultrasonography
Microbubbles
Placenta
Placenta accreta
