磁共振成像对凶险性前置胎盘的诊断价值分析

Analysis of diagnostic value of pernicious placenta previa examined by magnetic resonance imaging

目的探讨磁共振成像(magnetic resonance imaging,MRI)在凶险性前置胎盘(pernicious placenta previa,PPP)中的诊断有效性,分析PPP的影像学特征。方法选取2016年11月至2017年4月于深圳市宝安区妇幼保健院产科就诊的疑似PPP的产妇51例,对其术前MRI诊断结果进行诊断效能评价。结果经手术和病理检查确诊,确诊PPP患者48例(其中完全性42例,部分性4例,边缘性2例);合并胎盘植入33例(其中粘连性17例,植入性11例,穿透性5例)。MRI对PPP诊断敏感度为93.8%,特异度为40.0%,在诊断前置胎盘分型和胎盘植入程度方面一致性较高(P>0.05)。结论对于疑似PPP患者,MRI在判断胎盘位置、类型及是否伴有胎盘植入方面,灵敏度与特异性较高,值得临床推广应用。

Objective To investigate the diagnostic effectiveness of magnetic resonance imaging （MRI） in the diagnosis of pernicious placenta previa（PPP） ,and to analyze the imaging features of PPP. Methods This study included 51 cases suspected of PPP from November 2016 to April 2017 in Baoan District Maternal and Child Health Care Hospital. The patients underwent preoperative MRI examination and diagnosis, and the diagnostic efficacy of MRI was evaluated. Results 48 cases of PPP were diagnosed by operation and pathological examination, among which 42 cases were complete, 4 cases were partial, 2 cases were borderline;there were 33 cases of placenta accreta,included 17 cases of adhesion, 11 cases of implantation and 5 cases of penetrating. The sensitivity of MRI to the diagnosis of PPP was 93.8 % , the specificity was 40 % , and the consistency was high in the diagnosis of placenta previa classification and the degree of placenta implantation（ P 〉 0. 05 ）. Conclusion For patients with suspected PPP, MRI has high sensitivity in judging the location ,type of placenta and placenta acereta. It is worth referring, to clinical promotion.