中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2011年
8期
692-695
,共4页
焦岩%林桂凤%水旭娟%赵雅萍%金慧佩%张超%杨琰
焦巖%林桂鳳%水旭娟%趙雅萍%金慧珮%張超%楊琰
초암%림계봉%수욱연%조아평%금혜패%장초%양염
超声检查%微气泡%胎盘,侵入性%产后出血
超聲檢查%微氣泡%胎盤,侵入性%產後齣血
초성검사%미기포%태반,침입성%산후출혈
Ultrasonography%Microbubbles%Placenta accreta%Postpartum hemorrhage
目的 探讨超声造影诊断产后胎盘植入的临床价值。方法 回顾性分析产后胎盘植入患者26例。常规进行灰阶与彩色多普勒超声检查，超声造影观察宫腔内病灶、子宫肌层、浆膜层的造影剂灌注情况及增强特征。记录宫腔内病灶和正常子宫肌层的造影剂到达时间、达峰时间和增强持续时间等参数，比较病灶增强区域和正常子宫肌层之间各参数的差异。结果 26例患者的子宫增强顺序均为浆膜层、病灶及邻近子宫肌层、正常子宫肌层，宫腔内病灶及邻近子宫肌层之间界限不清，到达时间和达峰时间均早于正常子宫肌层(P＜0.05)，增强持续时间大于正常子宫肌层(P＜0.05)。部分病灶始终未见增强。其中24例显示子宫浆膜层光滑完整，后经保守治疗后子宫恢复正常。余2例病灶附近局部子宫浆膜层不光滑，但未见造影剂外溢，在保守治疗过程中持续出血，行子宫切除术及病理检查。结论超声造影能够清晰显示宫腔内病灶、子宫肌层和浆膜层的血流灌注情况及增强特征。
目的 探討超聲造影診斷產後胎盤植入的臨床價值。方法 迴顧性分析產後胎盤植入患者26例。常規進行灰階與綵色多普勒超聲檢查，超聲造影觀察宮腔內病竈、子宮肌層、漿膜層的造影劑灌註情況及增彊特徵。記錄宮腔內病竈和正常子宮肌層的造影劑到達時間、達峰時間和增彊持續時間等參數，比較病竈增彊區域和正常子宮肌層之間各參數的差異。結果 26例患者的子宮增彊順序均為漿膜層、病竈及鄰近子宮肌層、正常子宮肌層，宮腔內病竈及鄰近子宮肌層之間界限不清，到達時間和達峰時間均早于正常子宮肌層(P＜0.05)，增彊持續時間大于正常子宮肌層(P＜0.05)。部分病竈始終未見增彊。其中24例顯示子宮漿膜層光滑完整，後經保守治療後子宮恢複正常。餘2例病竈附近跼部子宮漿膜層不光滑，但未見造影劑外溢，在保守治療過程中持續齣血，行子宮切除術及病理檢查。結論超聲造影能夠清晰顯示宮腔內病竈、子宮肌層和漿膜層的血流灌註情況及增彊特徵。
목적 탐토초성조영진단산후태반식입적림상개치。방법 회고성분석산후태반식입환자26례。상규진행회계여채색다보륵초성검사，초성조영관찰궁강내병조、자궁기층、장막층적조영제관주정황급증강특정。기록궁강내병조화정상자궁기층적조영제도체시간、체봉시간화증강지속시간등삼수，비교병조증강구역화정상자궁기층지간각삼수적차이。결과 26례환자적자궁증강순서균위장막층、병조급린근자궁기층、정상자궁기층，궁강내병조급린근자궁기층지간계한불청，도체시간화체봉시간균조우정상자궁기층(P＜0.05)，증강지속시간대우정상자궁기층(P＜0.05)。부분병조시종미견증강。기중24례현시자궁장막층광활완정，후경보수치료후자궁회복정상。여2례병조부근국부자궁장막층불광활，단미견조영제외일，재보수치료과정중지속출혈，행자궁절제술급병리검사。결론초성조영능구청석현시궁강내병조、자궁기층화장막층적혈류관주정황급증강특정。
Objective To investigate the clinical value of contrast-enhanced ultrasound(CEUS) in the diagnosis of postnatal placenta increta. Methods Twenty-six patients with postnatal placenta increta were examined by gray-scale and color Doppler ultrasound and CEUS. Then microvascular perfusion and enhanced features of lesions, myometrium and serous layer were observed. Arriving time (AT), time to peak intensity (TTP) and the lasting time of enhancement (LTE) were recorded. AT,TTP and LTE of enhanced lesions were compared with those of normal myometrium. Results Serous layer, lesions and adjcent myometrium,normal myometrium enhanced in turn. There was no obvious boundary between the lesions enhanced and adjcent myometrium. AT and TTP of the lesions enhanced were both less than those of normal myometrium ( P ＜0. 05). LTE of the part of lesions enhanced was more than that of normal myometrium ( P ＜0.05).Part of lesions never enhanced during the whole process. The serous layer of uterine was smooth and uninterrupted in 24 patients. These 24 patients all recovered after conservative treatment. The local serous layer adjcent lesions was not smooth, but no contrast agent leakage occurred in another 2 patients, and uterine lobectomy were performed in emergency because of massive hemorrhage during conservative treatment. Conclusions Microvascular perfusion and enhanced features of lesions,myometrium and serous layer could be showed clearly through CEUS.
