论著-头颈部
胎儿生长受限的胎 盘MRI表现特点分析
作者:唐志会1 王 刚2 郝玉娟1
所属单位:1.河南省许昌市中心医院妇产科 (河南 许昌 461000) 2.河南省许昌市中心医院影像科 (河南 许昌 461000)
PDF摘要
目的 探讨胎儿生长受限的胎盘 MRI上的形态学及信号改变特征。方法 回 顾分析我院2015年7月-2018年2月采用核 磁共振(MRI)检查胎儿生长受限孕妇100 例,对孕妇子宫行矢、冠、轴面扫描,分 析孕妇影像资料,测量胎盘相关数值。 结果 胎儿生长受限的胎儿胎盘表现为胎 盘增厚呈球型,胎盘子宫附着面面积减 小,胎盘边缘附着处圆钝,部分伴有胎盘 梗死,表现为HASTE序列上中央高信号边 缘弥漫性信号改变;胎盘后出血,表现 为HASTE序列上胎盘下小片状低信号影; 绒毛膜下出血,表现为HASTE序列上绒毛 膜下小片状低信号影,胎盘MRI表现与孕 妇产后病理表现,差异无统计学意义(P >0.05);娩后死亡患儿19例,存活组新 生儿胎盘体积高于死亡组,差异有统计 学意义(P<0.05);存活组胎盘最大厚度 及胎盘最大厚度与胎盘体积比值低于对照 组,差异有统计学意义(P<0.05);胎儿 生长受限胎盘MRI胎盘体积与生产后测量 胎盘结果对照,差异无统计学意义(P> 0.05)。结论 MRI检查胎儿生长受限的胎 盘具有多种特征影像学表现,可用于临床 诊断。
Objective To investigate the morphological and signal-changing characteristics of placental MRI in fetal growth restriction. Methods A total of 100 cases of fetal growth restriction in pregnant women examined by MRI from July 2015 to February 2018 in our hospital were analyzed retrospectively. The uterus of the pregnant woman was examined by sagittal, crown and axial scans. The maternal image data was analyzed, the placenta-related values were measured. Results The placental with fetal growth restriction in fetus showed a thickening a spherical shape of the placenta. The area of the placenta uterus attachment surface was reduced, the placenta of attachment at the edge became circle bluntness, some were accompanied by placental infarction, expressing as a diffuse signal change in the central high signal edge on the HASTE sequence; After placental hemorrhage, it expressed as small platelet low signal shadow under placenta in HASTE sequence; there was subchorionic hemorrhage, expressing as small platelet low signal shadow under the chorion in HASTE sequence. There was no statistical difference between the expression of placental MRI and postpartum pathological expression in pregnant women (P>0.05); 19 children died after delivery, the placental volume of the newborn in the survival group was higher than that in the death group, the difference was statistically significant (P<0.05); The maximum thickness of the placenta and the ratio of the maximum thickness of the placenta to placenta volume in the survival group were lower than those of the control group (P<0.05). There was no significant difference between the placental volume of fetal growth restriction placenta MRI and the placenta after production (P>0.05). Conclusion MRI examination of placenta with fetal growth restriction has a variety of characteristic imaging performances and can be used for clinical diagnosis.
【关键词】胎儿生长受限;胎盘;核磁共振
【中图分类号】R445.2;R714.43
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2019.06.032
前言
胎儿生长受限又称宫内生长受限,是指胎儿在各种因素影响下未 达到生长全能[1]。美国妇产科学会将胎儿生长受限定义为胎儿出生体质 量低于同孕龄儿平均体质量第10百分位数,病因多样而复杂[2]。胎儿生 长受限的发生与胎盘血液灌注障碍有关,胎儿依靠母体有充分的营养 供应以及母体能将充分的营养通过血管分支输送入胎儿胎盘单位的能 力,任何损害母体内环境稳定的因素均可导致胎儿生长受限[3]。胎儿生 长受限的病因可概括为三个方面:母体因素、胎盘脐带因素以及胎儿 因素,其中胎盘功能不全是胎儿生长受限的常见原因[4]。胎儿生长受限 的主要检测手段是超声,但随着孕周增加,超声评估比较困难,核磁 共振(MRI)检查作为超声的补充检查,视野较大且分辨率较高,易于发 现胎盘病变特点[5]。本研究回顾性分析胎儿生长受限的胎盘孕妇资料, 分析其MRI表现特点,报告如下。
中国CT和MRI杂志
第17卷, 第 6 期
2019年06月
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