Sadeghi Ardakani Fatemeh, Tara Fatemeh, Mahmoud Ahmadzade Amir, Saghafi Nafiseh, Seilanian Toosi Farrokh, Khoroushi Farzaneh, Emadzadeh Maryam, Mirzaeian Sara, Aminzadeh Behzad
Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
J Ultrason. 2023 Feb 28;23(92):10-14. doi: 10.15557/JoU.2023.0002. eCollection 2023 Jan.
The accuracy of ultrasound findings in predicting the incidence of morbidly adherent placenta has been evaluated previously. In this study, we assessed the sensitivity and specificity of different quantitative findings of color Doppler and grayscale ultrasonography in predicting morbidly adherent placenta.
In this prospective cohort study, all pregnant women over 20 weeks of gestational age with anterior placenta and a history of previous cesarean section were evaluated for inclusion. Various ultrasound findings were measured. The non-parametric receiver operating characteristic curves, the area under the curve, and the cut-off values were assessed.
A total of 120 patients were ultimately included for analysis, of whom 15 had morbidly adherent placenta. The two groups were significantly different regarding the number of vessels. Based on color Doppler ultrasonography, in predicting the morbidly adherent placenta, more than two intraplecental echolucent zones with color flow had 93% and 98% sensitivity and specificity, respectively. According to grayscale ultrasonography, more than thirteen intraplacental echolucent zones had the sensitivity and specificity of 86% and 80% in predicting morbidly adherent placenta, respectively. Echolucent zone >11 mm at non-fetal surface had a sensitivity of 93% and a specificity of 66% in detecting morbidly adherent placenta.
According to the results, the quantitative findings of color Doppler ultrasound have considerable sensitivity and specificity in detecting morbidly adherent placenta. More than two echolucent zones with color flow are recommended as the main diagnostic parameter indicating the presence of morbidly adherent placenta with a sensitivity of 93% and a specificity of 98%.
超声检查结果预测胎盘植入发生率的准确性此前已得到评估。在本研究中，我们评估了彩色多普勒超声和灰阶超声不同定量检查结果预测胎盘植入的敏感性和特异性。
在这项前瞻性队列研究中，对所有孕周超过20周、前置胎盘且有剖宫产史的孕妇进行纳入评估。测量了各种超声检查结果。评估了非参数接收者操作特征曲线、曲线下面积和临界值。
最终共纳入120例患者进行分析，其中15例有胎盘植入。两组在血管数量方面有显著差异。基于彩色多普勒超声，在预测胎盘植入时，两个以上有血流的胎盘内无回声区的敏感性和特异性分别为93%和98%。根据灰阶超声，13个以上胎盘内无回声区预测胎盘植入的敏感性和特异性分别为86%和80%。非胎儿面无回声区>11mm检测胎盘植入的敏感性为93%，特异性为66%。
根据结果，彩色多普勒超声的定量检查结果在检测胎盘植入方面具有相当高的敏感性和特异性。建议将两个以上有血流的无回声区作为指示胎盘植入存在的主要诊断参数，其敏感性为93%，特异性为98%。
