前置胎盘伴胎盘植入的磁共振诊断价值

Diagnostic Value of MR Imaging in Placenta Previa with Placenta Accreta

目的探讨磁共振成像对前置胎盘伴胎盘植入的诊断价值。方法回顾性分析笔者医院34例因前置胎盘伴阴道流血入院孕妇,均行磁共振T2WI和DWI扫描,结果经手术及病理证实。测量植入与非植入性胎盘组织的表观弥散系数(ADC),分析T2WI、DWI序列及两者联合诊断胎盘植入的价值。结果 34例中,胎盘植入18例。植入性胎盘中植入与非植入部位及非植入性胎盘组织ADC值差异有统计学意义(P值分别为0.000、0.032)。T2WI和DWI序列及两者联合诊断胎盘植入的敏感度、特异性分别为83.3%、87.5%,66.7%、62.5%和94.0%、63.0%。结论 DWI对胎盘植入定性及定量诊断有一定参考价值。磁共振T2WI联合DWI序列可提高诊断胎盘植入的敏感度,减少漏诊率,增加诊断信息。

Objective To evaluate the diagnostic value of magnetic resonance imaging （MRI） in prenatal previa with placenta accreta （ PA）. Methods Thirty four eases of pregnant women with placenta previa and vaginal bleeding in our hospital were included in the study and analyzed, retrospectively. All cases underwent MRI T2WI and DWI sequence scan and the results were proved by surgery pathology. The apparent diffusion coefficient （ADC） value between implanted and non -implanted placenta were measured and the diagnostic value of T2WI, DWI and the two methods to PA were analyzed. Results In 34 cases with prenatal previa, 18 cases were proved placenta accreta. The difference of ADC value in implanted site, non - implanted site of placenta accreta and non - implanted placenta had statistical difference （P = 0. 000, 0. 032）. The sensitivity and specificity of T2WI, DWI and the two methods were 83.3% , 87.5% and 66.7% , 62.5% and 94.0% , 63.0% , respectively. Conclusion DWI has some reference value to the qualitative and quantitative diagnosis of placenta accreta. Combined with T2WI and DWI can improve the sensitivity, reduce the misdiagnosis rate and provide more informations for PA.