产后胎盘植入的MRI表现分析

Analysis of MRI images of placenta implantation

目的 :探讨产后胎盘植入的MRI特征,评价MRI对产后胎盘植入的诊断价值。方法 :回顾性分析13例产后胎盘部分或完全未娩出、经临床证实的胎盘植入患者资料,13例均行MRI平扫及增强扫描,分析其MRI特征。结果:13例子宫均不规则增大,局限性膨隆、变形,胎盘组织信号不均匀。胎盘下血管增多10例,胎盘组织与子宫肌层间见出血带8例。13例增强扫描胎盘组织强化程度稍高于子宫肌层,植入胎盘与宫壁融合,分界欠清,5例呈"花瓣样"不均匀强化。结论:产后胎盘植入的MRI征象主要包括子宫变形、局部隆凸,胎盘信号不均匀,胎盘下血管增多、出血带,"花瓣样"强化等。MRI能精确评价胎盘植入的类型和深度,是产后胎盘植入诊断的理想工具。

Objective ： To investigate the MRI imaging features of postpartum placenta implantation（ placental implantation abnormality,PIA）,and to evaluate the diagnostic value of MRI on postpartum PIA. Methods：A retrospective analysis of 13 cases of postpartum placenta partially or completely nondelivery,the data of placenta implantation were confirmed clinically,13 cases underwent MRI plain scan and enhanced scan,the MRI imaging features were analyzed. Results：All cases had irregularly enlarged uterus,limitation of swelling,deformation,placenta tissue signal heterogeneity. Placental vascular increased in 10 cases,bleeding between placental tissue and muscular layer of uterine in 8 cases. In 13 cases of enhanced scan,placental tissue enhancement degree was slightly higher than the muscular layer of uterus,placenta implantationand uterine wall fusion,boundary less clear,5 cases showed petal like inhomogeneous enhancement. Conclusion：MRI features of PIA include postpartum uterinedeformation,local protuberance,placenta signal heterogeneity,placental vessels increased,with placental hemorrhage,petal like enhancement,and so on. MRI can accurately evaluate the forms and the depth of placenta accreta postpartum,which is the ideal tool for diagnosis of PIA.