胎盘植入的MRI影像学表现

Magnetic Resonance Imaging features of placenta implantation

目的:探讨胎盘植入的MRI影像学表现。方法:回顾性分析7例胎盘植入患者的MRI影像学表现。其中4例产前检查仅行平扫,3例产后检查行平扫及增强扫描。结果:7例局部区域均可见胎盘与子宫肌层分界不清,其中4例位于子宫前壁,2例位于子宫底部,1例子宫底部及子宫前壁均可见;6例在T2WI上胎盘内可见多发低信号带状影,5例胎盘内可见多发迂曲增粗的血管流空影;4例产前检查中2例出现前置胎盘;3例产后增强扫描的患者中,在动脉早期,胎盘组织明显强化。结论:当超声检查不能为临床提供有价值的信息时,MRI检查成为诊断胎盘植入的最佳检查方式。胎盘-子宫交界不清,胎盘侵及子宫肌层、胎盘组织内低信号带影、胎盘内粗大血管流空影等影像学表现的存在均提示胎盘植入的可能。

Objective：To investigate the magnetic resonance imaging（MRI） features of placenta implantation. Methods：The MRI findings of placenta implantation in 7 cases were retrospectively analyzed,which included 4 cases treated with prenatally plain scan and 3 cases treated with postpartum plain and enhanced scan. Results：The boundary of placenta and myometrium in local region of 7 cases were unclear,which included 4 cases in the anterior wall of uterus,2 cases in the fundus of uterus and 1 case in the anterior wall and fundus of uterus. Multifocal low signal bands in placenta of 6 cases and flow void signals of multiple dilated tortuous vasculature in placenta of 5 cases were shown on T2-weighted images. Two cases with placenta previa were detected by prenatal examination,3 cases with strengthening placenta tissue were found by postpartum enhanced scan. Conclusions：MRI examination is the best way in diagnosing placenta implantation at the little value of Ultrasound examination. The unclear boundary of placenta and myometrium, placenta invading myometrium, low signal bands and flow void signals of multiple dilated tortuous vasculature hint the placenta implantation.