产前胎盘植入的MRI征象分析

Study of MRI Features of Prenatal Placenta Accreta

目的:分析胎盘植入的MRI影像特征,探讨MRI征象对产前胎盘植入的诊断价值。方法:收集41例产前B超怀疑胎盘植入的孕产妇资料,行盆腔MRI扫描。以病理及手术记录作为诊断标准,分为15例无胎盘植入对照组和26例胎盘植入组,分析产前MRI影像征象,比较MRI征象在两组间的差异性。同时测量T2WI上胎盘内低信号灶面积,分析其与胎盘植入类型的相关性。结果:MRI征象主要有:T2WI胎盘内低信号灶、胎盘局部血管增多、膀胱局部幕状突起、子宫局限膨隆。胎盘植入深度与T2WI上胎盘内低信号灶的面积呈相关性。结论:T2WI胎盘内低信号灶对胎盘植入的诊断具有很高应用价值。胎盘局部血管增多对胎盘植入诊断亦有较高价值。子宫局限隆起对胎盘植入具有提示作用。膀胱幕状突起对胎盘穿透具有提示作用。

Purpose： To analyze the MRI features of placenta accreta, and to explore the the diagnostic value of MRI in prenatal placenta accreta. Methods： Forty-one pregnant and lying-in women with placenta accreta according to antenatal ultrasound were undergone pelvic MRI scan. Taking the pathology results and surgical records as the standard of diagnosis, these 41 cases were divided into two groups： 15 cases without placenta accreta were taken as the control group, and the other 26 cases were taken as the placenta accreta group. Their prenatal MRI features were analyzed, and the differences of MRI features between the two groups were compared. Meanwhile, the areas of intraplacental low signal lesion on T2WI were measured, and its correlation with placenta accreta types was also analyzed. Results： The MRI features of placenta accrete were as the followed： low signal intensity lesions in the placenta on T2WI, increased blood vessels of the partial placental, partial bladder curtain-like projections, localized eminence of womb. The depth of placenta accrete was related to the area of intraplacental low signal intensity lesion on T2WI. Conclusion： Intraplacental low signal intensity lesions on T2WI and increase of blood vessels in the partial placenta have high diagnostic values for the placenta accreta. Localized eminence of womb would suggest the diagnosis of placenta accreta. Bladder curtain-like projections would suggest the placenta penetration.