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3D 超声血流成像联合血清 AFP、β-hCG、sFlt-1 和 CK 在胎盘植入诊断中的价值。

Value of 3D ultrasound flow imaging combined with serum AFP, β-hCG, sFlt-1 and CK in the diagnosis of placenta accreta.

机构信息

Department of Gynecology, Affiliated Matern&Child Care Hospital of Nantong University, 399 Century Avenue, Chongchuan District, Nantong, 226000, Jiangsu, China.

出版信息

BMC Womens Health. 2022 Dec 29;22(1):556. doi: 10.1186/s12905-022-02107-z.

Abstract

PURPOSE

To analyze the diagnostic value of placenta three-dimensional (3D) energy blood flow parameters combined with maternal serum AFP, β-hCG, sFlt-1 and CK levels for PA.

METHODS

30 pregnant women with PA and 30 pregnant women with normal placenta were randomly selected in the Affiliated Maternal and Child Health Hospital of Nantong University from January 2021 to December 2021. Thereafter, the 3D energy ultrasound was applied to detect the placenta VI, FI and VFI. Moreover, the diagnostic value of different parameters combined with serum AFP, β-hCG, sFlt-1 and CK levels for PA was analyzed.

RESULTS

Multivariate analysis results indicated that, gravidity > 2 and with/without placenta previa were the independent risk factors for PA (P < 0.05). In PA group, the AFP, β-hCG, CK, placenta VI, FI and VFI values were higher than those in non-PA group, while sFlt-1 was apparently lower than that in non-PA group. With the increase in PA degree, the serum AFP, β-hCG and CK levels increased. Meanwhile, serum sFlt-1 level was negatively correlated with PA degree. Serum AFP, β-hCG, sFlt-1, CK and placenta VFI showed prediction potency for PA, and their combined detection attained the optimal diagnostic value for predicting PA. ROC curve analysis suggested that, serum AFP, β-hCG, sFlt-1, CK and 3D ultrasound VFI value had the greatest AUC values in predicting PA, which might provide reference for the clinical diagnosis and disease evaluation of PA. Conclusion Serum AFP, β-hCG, sFlt-1, CK and placental VFI can increase the consistency in the diagnosis of PA. Serum markers combined with 3D ultrasound blood flow imaging can improve the sensitivity and specificity of prenatal diagnosis of PA, which provides an important reference for clinical diagnosis and treatment.

摘要

目的

分析胎盘三维(3D)能量血流参数与母血清 AFP、β-hCG、sFlt-1 和 CK 水平联合诊断胎盘疾病(PA)的价值。

方法

2021 年 1 月至 12 月,随机选取南通大学附属医院 30 例 PA 孕妇和 30 例正常胎盘孕妇。应用三维能量超声检测胎盘 VI、FI 和 VFI。分析不同参数与血清 AFP、β-hCG、sFlt-1 和 CK 水平联合对 PA 的诊断价值。

结果

多因素分析结果表明,孕次>2 次和胎盘前置与 PA 独立相关(P<0.05)。PA 组 AFP、β-hCG、CK、胎盘 VI、FI 和 VFI 值高于非 PA 组,sFlt-1 值明显低于非 PA 组。随着 PA 程度的增加,血清 AFP、β-hCG 和 CK 水平升高,而血清 sFlt-1 水平与 PA 程度呈负相关。血清 AFP、β-hCG、sFlt-1、CK 和胎盘 VFI 对 PA 有预测能力,联合检测对预测 PA 具有最佳诊断价值。ROC 曲线分析表明,血清 AFP、β-hCG、sFlt-1、CK 和 3D 超声 VFI 值对预测 PA 具有最大 AUC 值,可为 PA 的临床诊断和疾病评估提供参考。

结论

血清 AFP、β-hCG、sFlt-1、CK 和胎盘 VFI 可提高 PA 诊断的一致性。血清标志物联合 3D 超声血流成像可提高 PA 产前诊断的敏感性和特异性,为临床诊断和治疗提供重要参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0907/9798680/cca637895441/12905_2022_2107_Fig1_HTML.jpg

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