CAJ | 학술논문

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,超声造影与清宫术结果对比；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.
목적 탐토초성조영대태반식입적진단개치.방법 27례림상의사태반식입환자재상규초성검사후응용조영제SonoVue진행초성조영검사,실시관찰초성조영과정,분석조영제관주특점.결과 3례잉부중2례초성조영현시태반여기층분계청,인산후무태반잔류;1례잉부초성조영제시국부태반여기층분계소실,인산실패후부궁취태,술중견국부태반여궁벽점련긴밀,경겸협태반기본청제.20례산후환자진행보수치료,초성조영여청궁술결과대비；5례초성조영현시궁강잔류병조여자궁기층분계청초,15례궁강잔류병조국부여기층분계소실,기층미견변박.4례산후환자행자궁전절급차전절술,기초성조영여수술결과대비:초성조영현시잔류태반국부여기층분계소실、기층변박,장막완정,술중급병리균증실태반식입.결론 초성조영현시태반여기층분계소실,기층변박균제시유태반식입발생.
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 wail,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 dear 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.