二维超声、彩色多普勒与磁共振对前置胎盘植入的诊断价值评价

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摘要目的探讨二维超声、彩色多普勒超声以及磁共振(MRI)三种检查方法对前置胎盘植入的诊断价值。方法收集2012年6月—2015年6月期间四川省自贡市第四人民医院进行产前超声检查的孕产妇601例和同期在中国人民解放军总医院行MRI检查的孕产妇95例,共计696例孕产妇,根据检查方法分为二维超声组(286例)、二维+彩色多普勒超声组(315例)以及MRI组(95例),评价三种检查方法的诊断价值。结果只采用二维超声,灵敏度为78.3%,特异度为96.2%,阳性预测值64.3%,阴性预测值98.1%,与手术结果的一致性中等(K=0.677);采用二维超声+彩色多普勒,灵敏度87.1%,特异度94.7%,阳性预测值64.3%,阴性预测值98.5%,与手术结果的一致性中等(K=0.706);采用MRI检查灵敏度94.1%,特异度95.1%,阳性预测值91.4%,阴性预测值96.7%,与手术结果的一致性极佳(K=0.886)。三种检查方法在灵敏度、特异度、误诊率、漏诊率、阴性预测值等方面比较差异均没有统计学意义,但是MRI阳性预测值(91.4%)明显较高,差异有统计学意义。结论采用二维超声、彩色多普勒超声以及MRI检查在诊断胎盘植入的准确性、可靠性、预测值方面存在一些差异,但是各自均有一定优势,临床可根据实际情况选择单一手段检查或联合检查,以尽早诊断胎盘植入,减少误诊、漏诊。

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	缪娟
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	陈泽华

关键词 ：二维超声, 彩色多普勒, 磁共振, 前置胎盘植入, 诊断价值

Abstract：Objective To explore the value of two-dimensional ultrasound, color Doppler ultrasound and magnetic resonance imaging (MRI) in the diagnosis of implantation to placenta previa.Methods A total of 696 cases of pregnant women were divided into two-dimensional ultrasound group (286 cases), two-dimensional + color Doppler ultrasound group (315 cases) and MRI group (95 cases), and the diagnostic value of three kinds of methods was evaluated.Results The sensitivity of two-dimensional ultrasound was 78.3%, with specificity of 96.2%, positive predictive value of 64.3% and negative predictive value of 98.1%; the consistency with surgical results was medium (K=0.677). The sensitivity of two-dimensional + color Doppler was 87.1%, with specificity of 94.7%, positive predictive value of 64.3%, negative predictive value of 98.5%, and medium consistency with surgical results (K=0.706). The sensitivity of MRI was 94.1%, with specificity of 95.1%, positive predictive value of 91.4%, negative predictive value of 96.7%, and high consistency with surgical results (K=0.886). The differences among the three methods in sensitivity, specificity, misdiagnosis rate, missed diagnosis rate and the negative prediction value were not statistical significance (P>0.05). However, the positive predictive value of MRI (91.4%) was significantly higher than the other two methods, and the difference was statistically significant (P<0.05).Conclusion In terms of diagnosis accuracy, reliability and prediction values for the diagnosis of implantation to placenta previa, two dimensional ultrasound, color Doppler ultrasound and MRI showed some differences. However, each of method has its advantages, and therefore, a single or joint examination may be used to early diagnose placenta previa according to the situation presented.

Key words： Two dimensional ultrasound Color Doppler Magnetic resonance imaging Implantation to placenta previa Diagnostic value

收稿日期: 2016-01-07

引用本文:

缪娟, 李楠, 甘利路, 孙冲, 朱晓玲, 陈泽华. 二维超声、彩色多普勒与磁共振对前置胎盘植入的诊断价值评价[J]. 中国生育健康杂志, 2016, 27(6): 524-528.
LIAO Juan, LI Nan, GAN Lilu, SUN Chong, ZHU Xiaoling, CHEN Zehua. Evaluation of two-dimensional ultrasound, color Doppler and magnetic resonance imaging in the diagnosis of implantation to placenta previa. Chinese Journal of Reproductive Health, 2016, 27(6): 524-528.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2016/V27/I6/524

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