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目的探讨妊娠晚期剖宫产瘢痕部位胎盘植入的超声表现。方法回顾性分析31例经手术病理证实为剖宫产瘢痕部位胎盘植入的超声表现。结果 31例妊娠晚期剖宫产瘢痕部位胎盘植入主要超声表现为3种类型:Ⅰ型(5/31,16.1%):表现为胎盘后间隙消失,被胎盘组织占据,蜕膜强回声线消失,子宫肌层变薄(<2mm);Ⅱ型(19/31,61.3%):除具有Ⅰ型表现外,子宫肌层消失,胎盘内出现大小不等的静脉池,与胎盘后、宫壁上异常扩张的血管相通;Ⅲ型(7/31,22.6%):除具有Ⅱ型表现外,见子宫浆膜层中断,局部有血管及实质性块影突向膀胱,膀胱后壁不光滑或凸凹不平。结论妊娠晚期剖宫产瘢痕部位胎盘植入有典型的超声表现,胎盘与子宫肌层之间的蜕膜强回声线消失为胎盘植入的直接征象,胎盘植入部位血管异常扩张及胎盘内静脉池为最容易发现的超声表现。
Objective To investigate the ultrasound findings of cesarean section placenta accreta in late pregnancy. Methods A retrospective analysis of 31 cases confirmed by surgery and pathology for cesarean scar site placenta accreta ultrasound. Results There were 3 types of placenta accreta in 31 cases of cesarean scar in the third trimester of pregnancy: type Ⅰ (5 / 31,16.1%): the disappearance of the posterior placental space, the placenta tissue, the disappearance of the strong echo line of the decidua , Myometrium thinner (<2mm); type II (19 / 31,61.3%): in addition to the type Ⅰ performance, the myometrium disappeared, there are different sizes of the placental venous pool, and the placenta, the uterine wall Ⅲ type (7 / 31,22.6%): In addition to having Ⅱ type performance, see the uterine serosal disruption, local blood vessels and substantial block to the bladder, the posterior wall of the bladder is not smooth or Bumpy. Conclusions The placenta accreta in cesarean section at late pregnancy has a typical ultrasonic appearance. The disappearance of strong echo of the decidua between placenta and myometrium is a direct manifestation of placenta accreta. Abnormal expansion of blood vessels in the placenta and placental vein The pool is the most easily found ultrasound manifestation.