产前不同超声征象诊断胎盘植入价值的meta分析

发布时间：2018-06-23 02:08

本文选题：产前 + 超声　；参考：《现代妇产科进展》2017年05期

【摘要】：目的:应用meta分析探讨不同超声征象在产前诊断胎盘植入的价值。方法:检索2006年1月至2016年10月发表的有关产前不同超声征象评价胎盘植入的中英文文献,通过QUADAS-2评价系统对纳入的文献进行质量评价。用Review Manager 5.3和Meta-Di Sc 1.4软件绘制计算不同征象的敏感度、特异度绘制森林图,汇总敏感度(SEN)、汇总特异度(SPE)及相应的95%的置信区间(CI),得出阴性似然比和阳性似然比、诊断比值比(DOR),绘制综合受试者工作特征曲线(SROC),计算面积(AUC)。针对≥5篇文献报道过的超声征象纳入本研究。结果:共纳入12篇文献。结果显示,胎盘后间隙消失/破坏:SEN 0.83(0.78~0.88)、SPE 0.86(0.83~0.88)、AUC 0.9042;胎盘漩涡:SEN 0.71(0.67~0.76)、SPE 0.83(0.81~0.85)、AUC 0.8580;子宫膀胱交界面破坏:SEN 0.46(0.38~0.54)、SPE 0.98(0.96~0.99)、AUC 0.9083;胎盘/子宫膀胱交界面丰富血流信号:SEN 0.67(0.60~0.72)、SPE 0.95(0.93~0.96)、AUC 0.9470。结论:高危孕妇中,尤其是前置胎盘伴有剖宫产史或子宫手术史,上述超声征象在评估胎盘植入方面均具有一定的价值。判断胎盘漩涡时,应结合彩色多普勒漩涡内血流信号。所有征象中,多普勒示胎盘/子宫膀胱交界面丰富血流信号诊断准确性最高。
[Abstract]:Objective: to evaluate the value of different ultrasound signs in prenatal diagnosis of placenta accreta by meta analysis. Methods: Chinese and English literatures published from January 2006 to October 2016 on the evaluation of placenta accreta with different prenatal ultrasound signs were searched and evaluated by QUADAS-2 evaluation system. Using the software of Review Manager 5.3 and Meta-Di SC 1.4 to calculate the sensitivity, specificity, sum up sensitivity (SEN), aggregate specificity (SPE) and corresponding 95% confidence interval (CI) of different signs, the negative likelihood ratio and the positive likelihood ratio were obtained. The diagnostic ratio (DOR), the integrated operating characteristic curve (SROC) and the area (AUC) were drawn. Ultrasound signs reported in more than 5 articles were included in this study. Results: 12 articles were included. The results showed that the loss / destruction of the posterior placental space was 0.83 (0.780.88) SPE 0.86 (0.83n 0.88) AUC 0.9042, placental vortex: SEN 0.71 (0.670.76) and SPE 0.83 (0.81U 0.85) AUC 0.8580; uterine bladder interface damage 0.46 (0.38v 0.54) SPE 0.98 (0.960.99); placental / bladder interfacial signal SEN 0.67 (0.600.72) SPE 0.95 (0.930.96); UC0.90883; placental / bladder interfacial signal SEN 0.67 (0.600.72) SPE 0.95 (0.930.96). Conclusion: in high risk pregnant women, especially placenta previa with history of cesarean section or uterine surgery, these ultrasound signs have some value in evaluating placenta accreta. When judging the placental vortex, the blood flow signal should be combined with the color Doppler vortex. Among all the signs, the diagnostic accuracy of abundant blood flow signals at placenta / bladder interface was the highest on Doppler.
【作者单位】：山东大学齐鲁医院超声科;山东大学医学院;山东中医药大学附属医院;
【基金】：山东省重点研发计划(No:2015GSF118081)
【分类号】：R445.1;R714.2

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