胎盘早剥的声像图表现

目的探讨超声诊断胎盘早剥的临床价值及声像图特点。方法回顾性分析22例胎盘早剥患者的声像图表现及临床结局,结合患者临床表现行超声分型与临床分型对比分析。结果19例胎盘早剥患者的超声诊断与临床和病理诊断结果一致,超声诊断错误3例。其中超声诊断轻型胎盘早剥与病理符合3例(3/5),误诊2例(1例误诊为黏膜下肌瘤,1例误诊为胎盘囊肿);超声诊断重型胎盘早剥与病理诊断符合16例(16/17),1例超声仅表现为胎盘增厚而漏诊(1/17)。胎盘早剥临床类型及检查时期不同声像图表现不同,22例胎盘早剥患者中超声检出混合型13例,团块型6例,胎盘增厚型2例,积液型1例。结论重型胎盘早剥的声像图特点突出,超声检查能及时作出诊断,但胎盘剥离早期容易漏诊,应在母儿安全的情况下行超声动态观察。轻型胎盘早剥因胎盘剥离面积小,声像图表现多变,易漏诊或错误诊断,应结合临床及时对患者进行治疗和处理。

Special ultrasonographic features in the diagnosis of placental abruption

Objective To evaluate the value of ultrasonography in the diagnosis of placental abruption. Methods The sonographic images of 22 cases with placental abruption were reviewed retrospectively and the clinical urtrasound features were analysed and typed. Results Nineteen patients with placental abruption were diagnosed on ultrasonography proved by pathology. There were 3 patients were missed diagnosed. 3 patients were diagnosed as slight placental abruption. There were 2 patients were missed diagnosed. Sixteen patients with serious placental abruption were diagnosed correspondent with pathology. One patient with thickened placenta was missed diagnosed. Different clinical types and different examination times had different image characteristics. There were 4 types of images in placenta abruption. Conclusions Ultrasonography is valuable in the diagnosis of serious placental abruption, but it has limitations in the mild placental abruption.