产前超声检查和磁共振成像对胎盘植入诊断的准确性评估

Value of ultrasound and magnetic resonance imaging in prenatal diagnosis of placenta accreta

目的探讨产前超声检查和磁共振成像对胎盘植入的诊断价值。方法对于2010年11月至2014年11月间在首都医科大学附属北京妇产医院产前检查过程中曾因可疑胎盘植入同时进行超声检查以及磁共振成像检查的76例病例进行回顾性分析。产后病理检查以明确诊断,评价两种检查方法产前对胎盘植入的诊断价值。结果 76例患者中,术后病理诊断确诊为胎盘植入的共45例;超声诊断的胎盘植入45例,其中3例术后排除胎盘植入,漏诊3例;磁共振成像诊断的胎盘植入46例,其中3例术后排除胎盘植入,漏诊2例。两种检查方法的敏感度、特异度、精确比、诊断指数等方面比较差异无统计学意义(P>0.05);Kappa值分别为0.835和0.863(>0.4)。结论超声作为一项产前检查的常规项目,其对于胎盘植入的诊断价值是值得肯定的;彩超和磁共振检查作为产前诊断胎盘植入的主要手段,其诊断价值值得肯定;当超声结果为阴性或胎盘附着于子宫后壁时,磁共振成像可作为重要的补充检查方法。

Objective The purpose of the study was to evaluate the role of ultrasound（ US） and magnetic resonance imaging（ MRI） in the prenatal diagnostics of placenta accreta. Methods The study includes 76 pregnant women with suspected placenta accreta. The results of ultrasound and magnetic resonance imaging were compared. Results US and MRI showed no significant difference in sensitivity and specificity in diagnosing placenta accrete（ P 〉 0. 05）,and the Kappa values were 0. 835 and 0. 863,respectively Conclusion US is an accurate imaging modality for diagnosing placenta accrete,but when the US result is negative or the placenta is posteriorly located,MRI is more sensitive for the detection of the degree of placental invasion.