超声造影诊断胎盘植入的价值

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1、·236·中华超声影像学杂志2012年3月第21卷笫塑in望!h_堡旦．临床研究．超声造影诊断胎盘植入的价值林桂凤赵雅萍焦岩何慧疗张超杨琰【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

2、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。【关键词】超声检查；微气泡；胎盘；胎盘，侵入性Valueofcontrast-enhancedultrasoundindiagnosisofplacentalincretaLINGui-feng·ZHAOYa—ping，

3、JIAOYan，HEHui—liao，ZHANGChao，YANGYan．DepartmentofUltrasound，theSecondAffiliatedHospita10fWenzhouMedicalCollege，Wenzhou325027，ChinaC0rrs户0dgauthor：ZHAOYa—ping，Email：jane1953(sohu．com[Abstract]0bjectiveToevaluatethevalueofcontrast—enhanceduhrasound(CEUS)indiagnosisofplace

4、ntalincreta．MethodsTwentysevensuspectedpatientswithplacentalincretawereexaminedwithCEUSafterroutineultrasoundexamination．SonoVuewasinjectedintravenouslyasbolusandarealtimeCEUSwasperformed．ThecharacteristicsofcontrastperfusionW8Sanalysised．ResultsAmongthethreeantepartumC

5、EUScases，tWOhadaclearboundarybetweentheplacentaanduterinewall，therewasnoresidualplacentaafterinducedlabor；onehadablurboundarybetweenthelocalplacentaanduterinewall，andthelocalplacentaadherencedtOtheuterinewalltightlywhencesareansectionwasperformedafterinductionfailure．Co

6、mparisonbetweenCEUSanduterinecurettagein20cases，5caseshadaclearboundarybetweenresidua1diseaseinuterinecavityanduterinewal1．Theboundarybetweenresidualdiseaseinuterinecavityanduterinewalldisappearedinother15cases．Fourcasesperformedtotalandsubtotalhysterectomy，theuterinemy

7、ometriumofplacentaaffixingpartwereverythin(3—5mm)，andtheboundarybetweentheplacentaanduterinewalldisappeared，andplacentalincretawasprovedbyintraoperativeandpathology．ConclusionsWhentheboundarybetweenresidualplacentaanduterinewalldisappearedand／orthelocaluterinewallbecame

8、thin．placentalincretawassuggestedintensively．[Keywords]U1trasonography；Microbubbles；Placenta；Placentaaccreta胎盘