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Objective To explore the diagnostic value of ultrasonography and magnetic resonance imaging (MRI) in placenta accreta.Methods Totally 150 pregnancy women in Hunan Provincial Maternal and Child Health Care Hospital from January 2015 to December 2016 were selected into the clinical data.According to the location of the placenta in the uterus,150 pregnancy women were divided into the anterior (n =80) and posterior (n =70) groups.The sensitivity,specificity,positive predictive value and negative predictive value of ultrasound and MRI were calculated.The sonographic and MRI features between placenta implantation and non placental implantation were compared.Results There were no statistically significant difference for ultrasound and MRI sensitivity (96.43％ vs 85.71％,P =0.89),specificity (88.46％ vs 96.15％,P =0.37),positive predictive value (81.82％ vs 92.31％,P =0.95) and negative predictive value (97.87％ vs 92.59％,P =0.42) in anterior group.The MRI sensitivity (96.67％ vs 66.67％,P＜0.01),positive predictive value (96.67％ vs 83.33％,P ＜ 0.01) and negative predictive value (97.50％ vs 78.26,P ＜0.01) in the posterior group were higher than those in the ultrasound.Ultrasound showed that the incidence of localexpansion of the uterus and the increased placental vessels in placenta accreta was higher than that in non placental accreta (x2 =26.92,26.83,and 63.77,P ＜ 0.01).MRI showed that the incidence of local swelling,increased placental vascularity and low T2 signaling rates in placenta accreta was higher than that in non placental accrete (x2 =23.75,17.46,18.86,P ＜ 0.01).Conclusions Ultrasonography and MRI has high diagnostic value in placenta accreta.MRI is superior in the diagnosis of placenta accreta in the posterior uterus than in the anterior uterus.
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Objectives To construct reference range of fetal optic tract mean diameter and to report the measured optic tract mean diameter in fetuses with agenesis of the septum pellucidum (SP).Methods Three-dimensional volumes of the optic chiasm were acquired in 254 normal fetuses during routine sonographic examination at 21 ～ 40 weeks' gestation and the diameters of posterior left and right optic tracts were measured offline.A polynomial regression approach was used to calculate reference charts for the fetal optic tract mean diameter.In addition,16 three-dimensional volumes were acquired in fetuses with SP agenesis for offline measurement of optic tract diameter.The complete follow-up data were obtained in 7 of these 16 cases.Results In normal fetuses,the optic tract diameter increased linearly throughout gestation.Normal charts and equations were constructed.Among 7 fetuses with SP agenesis and complete follow-up,one had postnatal normal vision,two had hypoplastic optic tract,and four underwent termination of pregnancy.Three cases of normal childbirth were tested after the baby was born as a bundle of apparent dysplasia,including 1 case of neonatal characterized by lack of vision at the one year old and 2 cases of impaired vision.Four cases of termination of pregnancy included 1 case with tracking pathological confirmation of optic nerve hypoplasia,and the other 3 cases without tracking the pathological results.Conclusions We present new reference charts for fetal optic tract mean diameter.In fetuses with agenesis of the SP,sonography of the optic tract might be a useful tool to assess its development and may help prenatal counseling.
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Objective To compare three ultrasonic methods of transabdominal , transvaginal , and transperineal ultrasonogra-phy for the cervical length ( CL) in predicting the preterm birth .Methods The pregnancy women with threatened preterm labor in Hunan Provincial Hospital of Maternal and Child Health from January , 2012 to December, 2013 were chosen to measure the cervical length by sonography , and were randomly divided into three guoups ( 280 pregnancy women in each group ) , including Group Ⅰ( transabdominal ) , groupⅡ( transvaginal ) , and group Ⅲ ( transperineal ) .The cervical length and the pregnancy outcome were fol-lowed up.Results The acceptance rate of group Ⅱ(81.8%=229/280) was significantly lower than that of groupⅠ(100%=280/280)and group Ⅲ(99.3%=278/280)( P <0.05).The realization ratio of the cervix in group Ⅰ(85.0%=238/280) was signifi-cantly lower than that of group Ⅱ(98.7%=226/229) and group Ⅲ (98.2%=273/278) ( P <0.05).The preterm birth rate of 48.6%(18/37) in groupⅠ, 37.8%(28/74) in groupⅡ, and 37.1%(33/89) in groupⅢin the pregnancy women with CL <3 cm was significantly higher than the corresponding preterm birth rate of 17.9%(36/201) in groupⅠ, 13.2%(20/152)in groupⅡ, and 13.6% (25/184) in groupⅢin the pregnancy women with CL≥3 cm.The sensitivity of groupⅠ(33.3%=18/54) was significantly lower than that of group Ⅱ(58.3%=28/48) and group Ⅲ(56.9%=33/58).Conclusions The cervical length measured by ultra-sound is valuable in predicting preterm birth among the pregnancy women with threatened preterm birth .The transperineal ultrasonogra-phy is superior to transabdominal and transvaginal ultrasonography in predicting preterm birth , and is worth being popularized .
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Objective To investigate the proportion of different types, distribution of genders, ages as well as the relative factors in inpatient with glaucoma. Design Retrospective case series. Participants 5058 cases of inpatients in Xingtai Eye Hospital, Hebei province from June 2004 to May 2009 were included. Methods Statistical analysis was conducted for 5058 cases of inpatients with glausoma. Main outcome Measures The type of glaucoma, age, gender and their percentages. Results In all 5058 cases, the patients with primary glaucoma, secondary glaucoma and congenital glaucoma accounted for 59.07%, 37.92% and 3.01% respectively. Primary angle-closure glaucoma (PACG) accounted for 88.65% in primary glaucoma, and primary open angle glaucoma (POAG) accounted for 11.35%. In PACG, acute PACG accounted for 53.15%, chronic PACG 46.85%;The female over forty accounted for 69.54%, male 26.95%. In POAG, the female over forty accounted for 69.54%, male 28.02%. From June 2004 to May 2005, POAG accounted for 11.32% in primary glaucoma, 12.44% from June 2008 to May 2009. There was no statistically significant difference. Conclusion In the central part of China, the majority of inpatients with glaucoma was PACG. It may relate to the regional,economic and cultural conditions.