Gong Lili, Zheng Lipeng, Gao Junhui, Chang Hongbo, Liu Ying, Wang Yingluan
Department of Ultrasound, Zibo Municipal Hospital, Zibo, China.
J Ultrasound Med. 2025 Feb;44(2):189-194. doi: 10.1002/jum.16595. Epub 2024 Oct 3.
To explore the value of applying flow high definition (HD) glass body in prenatal diagnosis of vasa previa and to preliminarily discuss the types of vasa previa.
Two-dimensional ultrasound, flow HD, and flow HD glass body were used to image the umbilical cord insertion site and placenta, observe the cervical internal os and surrounding areas, and retrospectively analyze cases of vasa previa.
There were 15 cases of vasa previa, including 14 cases of singleton pregnancies and 1 case of twin pregnancy, with a total of 22 vasa previa, including 10 veins and 12 arteries. There was 1 case with 3 vessels, 5 cases with 2 vessels, and 9 cases with a single vessel. Among them, in 3 cases of vasa previa detected at 12, 14, and 24 weeks, respectively, the vasa previa were relocated to a normal position at 24, 29, and 35 weeks of gestation when re-examined. Routine 2-dimensional ultrasound examination in this group showed tubular or circular hypoechoic areas near the cervical internal os, but vasa previa could not be confirmed. Flow HD could display color blood flow at and near the cervical internal os in 15 cases, but it was difficult to continuously show the course and source of the blood vessels under the chorion. Flow HD glass body from multiple angles could display the relationship between 15 cases of 22 vasa previa and the placenta and cervix. Combined with color Doppler blood flow spectra, flow HD glass body could determine the types of vasa previa.
Flow HD glass body imaging can clearly display vasa previa, showing their origin and the spatial relationship with the cervix and placenta in a 3-dimensional manner, displaying the course and attachment points of umbilical vessels under the chorion. It can observe the area of interest at any angle, and combined with color Doppler blood flow spectra, it can judge the vasa previa of the umbilical vein, providing a more definite imaging basis for clinical management.
探讨应用血流高清玻璃体成像在前置血管产前诊断中的价值,并初步探讨前置血管的类型。
采用二维超声、血流高清成像及血流高清玻璃体成像对脐带插入部位及胎盘进行成像,观察宫颈内口及周围区域,并对前置血管病例进行回顾性分析。
共15例前置血管,其中单胎妊娠14例,双胎妊娠1例,共22条前置血管,包括10条静脉和12条动脉。1例有3支血管,5例有2支血管,9例有1支血管。其中,分别在孕12、14和24周检测出的3例前置血管,在孕24、29和35周复查时前置血管位置恢复正常。该组常规二维超声检查显示宫颈内口附近有管状或圆形低回声区,但不能确诊前置血管。血流高清成像能显示15例宫颈内口及附近的彩色血流,但难以连续显示绒毛膜下血管的走行及来源。血流高清玻璃体成像从多个角度能显示22条前置血管中的15条与胎盘及宫颈的关系。结合彩色多普勒血流频谱,血流高清玻璃体成像可确定前置血管的类型。
血流高清玻璃体成像能清晰显示前置血管,以三维方式显示其起源及与宫颈和胎盘的空间关系,显示绒毛膜下脐血管的走行及附着点。能从任意角度观察感兴趣区域,结合彩色多普勒血流频谱,可判断脐静脉前置血管情况,为临床处理提供更确切的影像学依据。