探讨胎盘残留超声造影临床应用价值。

对2013年1月至2015年12月四川省人民医院病理诊断为胎盘残留并经临床治愈的84例患者的术前腹部常规超声及超声造影图像特征进行研究，根据病理诊断结果进行分组（单纯胎盘残留组25例，胎盘植入组59例）。

84例胎盘残留患者产后超声表现：单纯胎盘残留组患者宫腔内残留病灶的增强方式多表现为慢进（88.0%，22/25）、呈高增强或等增强（76.0%，19/25）、病灶内增强不均匀（84.0%，21/25）、造影后宫腔内病灶与子宫肌层分界清楚（88.0%，22/25）、边界规整（92.0%，23/25）、病灶附着处子宫肌层较对侧正常子宫肌层无明显变薄（84.0%，21/25）；胎盘植入组患者宫腔内残留病灶的增强方式多表现为快进（96.6%，57/59）、呈高增强或等增强（88.1%，52/59）、病灶内增强不均匀（93.2%，55/59）、造影后宫腔内病灶与子宫肌层分界不清（84.7%，50/59）、边界不规整（88.1%，52/59）、病灶附着处子宫肌层较对侧正常子宫肌层变薄（76.3%，45/59）。与病理诊断结果比较，常规超声和超声造影诊断胎盘残留与病理诊断的符合率分别为71.4%（60/84）、91.6%（77/84）。

超声造影能发现产后宫腔内残留病灶并清楚地显示其内的血流状况，超声造影的增强特征有助于鉴别产后宫腔内残留病灶有无植入子宫肌层，为临床治疗提供准确信息，有重要临床应用价值。

To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) in residual placenta.

The transabdominal conventional ultrasound and CEUS findings of 84 patients with residual placenta that were confirmed by pathological and clinically cured from January 2013 to December 2015 in Sichuan Provincial People?s Hospital were reviewed before surgery. Based on the pathological findings, the presence of chorionic villus adjacent myometrium was defined as the implanted group (59 cases) and the presence of residual placenta was defined as the non-implanted group (25 cases).

The main CEUS features of the non-implanted group were slow flow-in (88.0%, 22/25), hyperenhancement or isoenhancement (76.0%, 19/25), heterogeneous enhancement (84.0%, 21/25), clear boundary between lesions and myometrium (88.0%, 22/25), regular boundary (92.0%, 23/25), the muscle thickness in the lesion area was not decreased when compared with the contralateral normal myometrium (84.0%, 21/25). The main CEUS features of the implanted group were fast flow-in (96.6%, 57/59), hyperenhancement or isoenhancement (88.1%, 52/59), heterogeneousen hancement (93.2%, 55/59), not-clear displayed in boundary (84.7%, 50/59), boundary irregularity (88.1%, 52/59), the muscle thickness in the lesion area decreased when compared with the contralateral normal myometrium (76.3%, 45/59). Compared with the pathological diagnosis, the pathological coincidence rate of ultrasound and CEUS in the diagnosis of residual placenta were 71.4% (60/84), 91.6% (77/84).

CEUS can demonstrate intrauterine residual lesions and the features of it are helpful in differential diagnosingre sidual placenta. To sum up, CEUS can provide more accurate information and application value.