论著-头颈部
磁共振成像在前置胎盘诊断中的价值分析
作者:赵 嵩1 陈志敏2 安莲英1 彭丽霞1 崔蕾蕾1 许志琴1
所属单位:1.河南省平顶山市第二人民医院妇 产科 (河南 平顶山 467000) 2.郑州大学第一附属医院产一科 (河南 郑州 450052)
PDF摘要
目的 探讨磁共振成像(MRI)对前 置胎盘的诊断价值,为评估预后而提供依 据。方法 回顾性分析58例前置胎盘患者 的临床资料,其中26例前置胎盘患者并发 胎盘植入;对所有患者进行MRI及超声检 查,并分析对比MRI及超声检查对前置胎 盘的诊断符合情况;将58例前置胎盘患者 是否并发胎盘植入进行分组,分为胎盘植 入组和对照组,对比两组患者的MRI影像 特征,分析前置胎盘并发胎盘植入的特异 性MRI影像特征。结果 MRI对前置胎盘的 诊断符合率为100%,未出现漏诊及误诊 的病例,超声对前置胎盘的诊断符合率 为79.31%,其中漏诊1例,误诊11例;MRI 与超声对前置胎盘的诊断符合率具有显著 性差异(P<0.05);胎盘植入组和对照组 的MRI影像特征对比,胎盘植入组和对照 组的子宫下段变形或局部隆起、T2WI像出 现低信号暗带、植入局部流空血管影增多 均具有统计学差异(P<0.05)。结论 MRI 对前置胎盘的诊断价值显著大于超声,诊 断符合率高,且并发胎盘植入的患者具有 特征性MRI征象,有利于评估前置胎盘的 预后,为临床及时采取干预措施而提供依 据。
Objective To investigate the magnetic resonance imaging (MRI) of the diagnostic value of placenta previa, and provide the basis for assessing the prognosis. Methods Retrospective analysis of clinical data of 58 cases of patients with placenta previa, in which 26 cases of patients with placenta previa placenta accreta, all patients MRI and ultrasound, and the analysis and comparison of MRI and ultrasonography in the diagnosis of placenta previa compliance, the 58 cases of patients with placenta previa combined with placenta implantation whether grouped into placental implantation and control groups, comparing MRI imaging features two groups of patients, analytical specificity MRI imaging features of placenta previa placenta accreta. Results MRI in the diagnosis of placenta previa rate was 100.00%, of cases of misdiagnosis and missed diagnosis does not appear, ultrasound diagnosis of placenta previa rate was 79.31%, which missed 1 case misdiagnosed 11 cases. MRI and ultrasound of the former diagnosis of placenta previa compliance rate has significant difference (P<0.05). MRI imaging features of placenta accreta group and control group comparison, the lower uterine segment placenta implantation and control groups deformation or local doming, T2WI image appears low signal dark with implanted locally increased vascular flow void Movies were significant differences (P<0.05). Conclusion The diagnostic value of MRI for placenta previa was significantly greater than the ultrasound diagnosis rate, and patients with placenta accreta concurrent with characteristic MRI findings will help evaluate placenta previa prognosis for clinical interventions and provide timely basis.
【关键词】前置胎盘;磁共振成像;诊断
【中图分类号】R714.56;R445.2
【文献标识码】A
【DOI】10.3969/j.issn.1672- 5131.2016.07.029
前言
前置胎盘是指孕龄超过28周后,胎盘与子宫下段的附着程度加 大,逐渐靠近宫颈口,且下缘低于胎儿先露部[1]。在临床上,前置胎 盘的主要表现为反复无痛性阴道出血,缺乏特异性;而胎盘植入作为 前置胎盘的常见并发症,以产后胎盘剥离延迟、子宫收缩程度低作为 主要表现,显著增大产后大出血的风险。对此,提高对前置胎盘的诊 断水平,密切随访监测胎盘低置孕妇,评估前置胎盘并发胎盘植入的 风险,有利于为及时采取干预措施而提供依据,作为改善该病预后的 关键。超声检查作为筛查及诊断前置胎盘的传统影像学方法,但临床 仍存在误诊或漏诊的病例;近年来,磁共振成像(MRI)逐渐用于诊断前 置胎盘,评估胎盘植入的发生风险具有重要价值,对母体及胎儿无有 害的报道[2]。对此,本研究旨在探讨MRI对前置胎盘的诊断价值,为评 估预后而提供依据。
中国CT和MRI杂志
第14卷, 第 7 期
2016年07月
相关文章