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中华医学超声杂志(电子版) ›› 2017, Vol. 14 ›› Issue (05) : 349 -353. doi: 10.3877/cma.j.issn.1672-6448.2017.05.005

所属专题: 文献

妇产科超声影像学

探头下孕妇腹壁低频振动法对膜状胎盘的诊断
马娅1, 张居杰1, 杨晓娟1,()   
  1. 1. 730050 甘肃,兰州市第一人民医院功能科
  • 收稿日期:2017-02-06 出版日期:2017-05-01
  • 通信作者: 杨晓娟

Study on the diagnosis of placenta membranacea using a new method of abdominal wall low frequency vibration

Ya Ma1, Jujie Zhang1, Xiaojuan Yang1,()   

  1. 1. Department of Function, the First People′s Hospital of Lanzhou City, Lanzhou 730050, China
  • Received:2017-02-06 Published:2017-05-01
  • Corresponding author: Xiaojuan Yang
  • About author:
    Corresponding author: Yang Xiaojuan, Email:
引用本文:

马娅, 张居杰, 杨晓娟. 探头下孕妇腹壁低频振动法对膜状胎盘的诊断[J/OL]. 中华医学超声杂志(电子版), 2017, 14(05): 349-353.

Ya Ma, Jujie Zhang, Xiaojuan Yang. Study on the diagnosis of placenta membranacea using a new method of abdominal wall low frequency vibration[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(05): 349-353.

目的

探讨探头下孕妇腹壁低频振动法诊断膜状胎盘的价值。

方法

选择怀疑膜状胎盘及其他胎盘异常的孕妇36例,采用探头下孕妇腹壁低频振动法进行检查,振动频率为3~5次/s,每次持续振动时间不超过3 s,然后立即对胎盘进行观察,记录胎盘内部回声的变化,并在同一位置再次测量胎盘的厚度,比较膜状胎盘与其他胎盘异常的回声特征。

结果

36例胎盘异常者,胎盘娩出后最终确诊为完全性膜状胎盘2例,部分性膜状胎盘16例,胎盘血窦15例,胎盘绒毛膜血管瘤3例。完全性膜状胎盘和部分性膜状胎盘的膜状化部分在探头低频振动前和振动后超声声像图表现明显不同,均表现为由均匀一致的高回声变为漩动的高低回声相互变化的非均匀回声,呈流动状或漩涡状的"漩动状"胎盘。而非膜状化部分和胎盘其他异常在探头低频振动前后无此声像特征。

结论

探头下孕妇腹壁低频振动法是识别与诊断膜状胎盘的有效方法。这种在低频振动后出现回声不均匀和明显"漩动状"的胎盘声像特征,是识别与诊断膜状胎盘的特征性声像,也是区别于胎盘其他异常的可靠鉴别诊断特征。

Objective

To study the value of the new method of abdominal wall low frequency vibration (AWLFV) by prenatal ultrasound in diagnosis and differential diagnosis of placenta membranacea (PM).

Methods

Thirty-six cases of abnormal placenta were enrolled into the study. AWLFV was used in all 36 cases. The vibration was conducted with a frequency of 3 to 5 times per second and a duration less than 3 seconds at a time. And then the placenta was immediately observed to record the placenta echogenicity changes, and in the same place the thickness of the placenta was measured. The echo characteristics of PM and other abnormal placenta was compared.

Results

Thirty-six cases were finally diagnosed as complete PM in 2 cases, partial PM in 16 cases, placental sinus in 15 cases, and placental chorionic hemangioma in 3 cases. The echo characteristics of complete and partial PM were obviously different before and after AWLFV on ultrasonic image. The homogeneous echotexture of PM before AWLFV was changed immediately to the inhomogeneous echotexture after AWLFV. The ″spiral shape″ of the placenta was displayed. And in other plasental anomalies this feature was not observed before and after vibration.

Conclusion

The AWLFV is an effective method in diagnosis and differentiation of PM.

图3,4 孕36周胎儿,部分性膜状胎盘,采用探头下孕妇腹壁低频振动法后胎盘内部回声由振动前的均匀高回声(图3)变为高低相间的片状不规则回声,实时超声下高低回声交替,呈漩动状(图4)
表1 36例胎盘异常腹壁低频振动法检查前后超声表现
表2 36例胎盘异常超声表现及妊娠结局
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