目的 分析前置胎盘伴胎盘植入 的危险因素和产前MRI对前置胎盘胎盘植 入的诊断价值。方法 回顾性分析2016年 1月至2017年1月我院96例前置胎盘伴植 入患者(研究组)和同期128例前置胎盘 未伴植入患者(对照组)的临床资料，其 中130例患者因疑似伴胎盘植入行产前 MRI检查。经logistic回归分析影响前置 胎盘伴胎盘植入的独立危险因素。观察 MRI对前置胎盘伴胎盘植入及植入分型的 诊断价值。结果 2组患者怀孕方式、孕 次、产次、流产次数、剖宫产次数、宫 腔手术史等资料比较差异有统计学意义(P ＜0.05)。logistic回归分析显示：流产 次数≥2次、剖宫产次数≥1次、有宫腔手 术史是影响前置胎盘伴胎盘植入发生的独 立危险因素(P＜0.05)。MRI诊断前置胎盘 伴胎盘植入的灵敏度、特异度、准确率、 阳性预测值及阴性预测值分别为81.25%、 94.12%、84.62%、97.50%、64.00%，与手 术病理诊断前置胎盘伴胎盘植入分型符合 率为73.08%。结论 MRI对前置胎盘伴植 入诊断效果良好，对于具备流产次数≥2 次、剖宫产次数≥1次、有宫腔手术史等 影响前置胎盘伴胎盘植入危险因素的患者 应予以重视，及时进行MRI等检查。  

Objective To analyze the risk factors of placenta previa with placenta accreta and the diagnostic value of prenatal MRI on placenta previa with placenta accreta. Methods The clinical data of 96 patients with placenta previa and placenta accreta (study group) and 128 patients with placenta previa but without placenta accreta (control group) from January 2016 to January 2017 were analyzed retrospectively, among which 130 patients with suspected placenta accreta were given preoperative MRI. Logistic regression analysis was used to analyze the independent risk factors affecting placenta previa with placenta accreta. The diagnostic values of MRI in placenta previa with placenta accreta and implant classification were observed. Results There were significant differences in the data of pregnancy way, gravidity, parity, abortion frequency, cesarean section frequency and history of uterine surgery between the two groups (P<0.05). Logistic regression analysis showed that abortion frequency≥ 2 times, cesarean section frequency ≥ 1 time and history of uterine surgery were independent risk factors for placenta previa with placenta accreta (P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MRI in the diagnosis of placenta previa with placenta accreta were 81.25%, 94.12%, 84.62%, 97.50% and 64.00% respectively, and the coincidence rate with pathological diagnosis of implant classification of placenta previa with placental accreta was 73.08%. Conclusion MRI has a good diagnostic effects on placenta previa with placenta accreta. Patients with abortion frequency ≥ 2 times, cesarean section frequency ≥ 1 time and history of uterine surgery and other factors affecting the risk factors of placenta previa with placenta accreta should be taken seriously and given timely MRI and other examinations.