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Objective To explore the value of two dimentional colour Doppler flow image (2D-CDFI) combined with three-dimensional color power angiography (3D-CPA) in diagnosis of placenta accreta.Methods A total of 43 pregnant women at risk of placenta accreta selected from September 2010 to August 2015 were enrolled,and underwent 2D-CDFI and 3D-CPA to scan entire placenta.Taking the results of clinical outcome and delivery pathology of the placenta as standard,the ultrasound characteristics of 2D-CDFI and 3D-CPA were analyzed.Results Taking the results of clinical outcome and delivery pathology of the placenta as standard,24 were proved with placenta increta,3 patients with adherent placenta,2 patients with placenta percreta,14 patients with no placenta implantation.Out of 43 cases,29 cases displayed the placental thickening and rich blood vessels in placenta,and at interface of placenta and bladder wall in 2D-CDFI.For 2D-CDFI,19 cases were correctly diagnosed with placenta accrete,while 6 cases were mis-diagnosed and 4 cases missed diagnosed,the diagnosis coincidence rate by 2D-CDFI was 65.5％ (19/29).The ultrasound characteristics displayed irregular arranged myometrial arcuate artery,rich blood vessels at interface of placenta and bladder wall in 3D-CPA.For 3D-CPA,23 cases were correctly diagnosed with placenta accrete,3 cases were misdiagnosed,the diagnosis coincidence rate by 3D-CPA was 79.3％ (23/29).For 3D-CPA combined 2D-CDFI,1 case missed diagnosed,the diagnosis coincidence rate by combination 2D-CDFI with 3D-CPA was 96.6％ (28/29).Conclusions Placenta accrete can all be prenatally diagnosed by characteristic ultrasonic features of 2D-CDFI and 3D-CPA.But 3D-CPA can clearly display the range of placenta accrete lesions and the depth of the blood vessels diffused,has more advantage than two-gray scale ultrasound and 2D-CDFI and has broad application in clinic.
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Objective:To evaluate right heart remodeling and right heart function change after pulmonary resection by echocardiography (ECG) .Methods:A total of 50 patients undergoing pneumonectomy received ECG examination to evaluate right ventricular structure and right heart function change before and after partial pulmonary resection .Re-sults:(1) Compared with before operation , there were no significant changes in right ventricular anterior free wall thickness ,right ventricular ejection fraction on 7d and 30d after operation;(2) Compared with before treatment , there were significant rise in pulmonary artery systolic pressure [PASP ,(20.52 ± 2.46) mmHg vs .(49.65 ± 2.17) mmHg] ,pulmonary artery diastolic pressure [PADP ,(10.82 ± 2.04) mmHg vs .(21.93 ± 1.26) mmHg] and pul-monary artery mean pressure [PAMP ,(13.78 ± 3.67) mmHg vs .(26.67 ± 3.28) mmHg] ,and significant rise in pulmonary vascular resistance [PVR ,(187.69 ± 12.46) dyn .s .cm-1 vs .(368.72 ± 11.94) dyn .s .cm-1 ] on 7d after pulmonary resection , P<0.05 all;all above indexes recovered to normal on 30d after treatment ;(3) Com-pared with before operation ,right ventricular Tei index significantly rose [ (0.36 ± 0.05) vs .(0.69 ± 0.13) , P=0.04] on 7d after operation ,the Tei index recovered to normal on 30d after treatment ,P=0.20. Conclusion:Com-pared with before operation , the PASP ,PADP and PAMP significantly rise on 7d after operation ,they recover to normal on 30d after treatment ;there are no significant change in right ventricular structure .
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ObjectiveTo investigate the diagnosis value of intracardiac echocardiography in cesarean section scar pregnancy. MethodsCavity ultrasound was applied in patients of cesarean scar pregnancy with sonographic features and treatment. ResultsIn 52 patients, ultrasound diagnosed accurately in 45 cases, diagnosis accurate rate was 86.5％ (45/52). Sonogram showed gestational sac simply type in 16 cases, mixed echo-type( or mass-based) of 36cases. In 52 cases of CSP, according to their clinical and sonographic features ,2 cases of uterine scar lined laparotomy and the uterus excision repair;three cases of laparoscopic removal of uterine scar pregnancy lesion repair. 6 patients to methotrexate;five cases of abdominal surgery;36 routine uterine arterial embolization in the ultrasound monitor after curettage. ConclusionUltrasound could apply in cesarean scar pregnancy timely,and accurate diagnosis was made;sonographic features according to the patients,help choose the appropriate clinical treatment,and assess efficacy.