MRI在胎盘植入中应用研究

Study on the Application of MRI in Placenta Implantation

目的研究磁共振成像(MRI)在胎盘植入中的应用价值。方法回顾性分析本院2014年1月-2016年6月行超声、MRI检查的100例可疑胎盘植入患者临床资料,以术后病理结果为金标准,比较超声、MRI诊断敏感度、特异度及准确度,并以50例无胎盘植入孕妇为正常对照组,比较两组MRI征象。结果术后病理确诊为胎盘植入60例,MRI诊断敏感度、特异度、准确度分别为83.33%、95.00%、88.00%,较超声的75.00%、90.00%、81.00%差异无统计学意义(P>0.05);胎盘植入与无胎盘植入正常对照组在胎盘与子宫交界面波浪状改变、胎盘附着处肌层变薄或缺失、子宫梨形消失、胎盘内条状低信号、胎盘内血管影增多、子宫壁或宫旁血管增多、子宫浆膜层信号中断或缺失MRI征象上比较差异显著(P<0.05)。结论超声、MRI对胎盘植入诊断效果类似,胎盘附着处肌层变薄或缺失、子宫壁或宫旁血管增多等可作为胎盘植入与无胎盘植入判断重要MRI征象。

Objective To study the application value of magnetic resonance imaging （MRI） in placenta Implantation. Methods The clinical data of 100 patients with suspected placenta implantation who underwent ultrasound examination and MRI in our hospital between January 2014 and June 2016 were analyzed retrospectively. With postoperative pathological results as the golden standard, the diagnostic sensitivity, specificity and accuracy were compared between ultrasound and MRI. Another 50 pregnant women without placenta inxplantation were included into normal control group, and MRI signs were compared between the two groups. Results Postoperative pathology diagnosed 60 cases with placenta implantation. The diagnosnc sensitivity, specificity and accuracy of MRI were 83.33%, 95.00% and 88.00%. respectively. Compared with those of ultrasound （75.00%. 90.00% and 81.00%）, there were no significant differences （P〉0.05）; The wave like changes at interface of placenta and uterus, muscle layer becoming thinner or absent at placenta attachment sites, uterine pyriform disappearance, striped low signal in placenta, placental vascular shadow increasing, uterine wall or vessels around uterus increasing, perimetrium signal interruption or loss and other MRI signs showed no significant differences between the two groups （P〈0.05）. Conclusion The effects of ultrasound and MRI are similar in the diagnosis of placenta implantation. Muscle layer becoming thinner or absent at placenta attachment sites and increase of uterine wall or uterine blood vessels can be used as an important MRI sign for diagnosis of placenta implantation.