MRI对孕晚期胎盘异常的诊断价值

MRI diagnosis of prenatal placental abnormality to late pregnant women

目的探讨MRI对孕晚期胎盘异常的诊断价值。方法纳入41例孕妇,年龄22-41岁,平均年龄29岁,孕周30~38周,平均孕周35周。产前临床怀疑或超声提示胎盘异常且可行磁共振成像(MRI)检查,采用二维快速平衡稳态采集序列(2D FIESTA)、弥散加权序列(DWI)、三维容积内插快速扰相梯度回波序列(LAVA)或T1加权成像(T1WI)序列行子宫的常规横断面、矢状面及母体的冠状面扫描,将产前MRI表现与手术结果进行对照。结果 MRI结果显示41例孕妇中40例胎盘发现异常,漏诊胎盘粘连植入1例。前置胎盘30例,其中胎盘低置5例,边缘型前置胎盘4例,部分型前置胎盘6例,完全性前置胎盘15例;胎盘植入31例,胎盘剥离并血肿形成3例,2例为胎盘后剥离,1例为胎盘后及羊膜下剥离并血肿同时存在,胎盘内出血1例。超声诊断仅显示35例胎盘异常。结论 MRI在孕晚期胎盘异常诊断方面具有极高的应用价值。

Objective To investigate the clinical diagnostic value of magnetic resonance imaging （MRI） to prenatal placental abnormality of late pregnant women. Methods 41 gravidas aged from 22 to 41 years old with the mean age of 29 and mean gesta- tional weeks of 35 were enrolled to this study. Suspicious placental abnormality had been reported after clinical or ultrasound diagno- sis for all pregnant women, which received the MRI examination including 2D FIESTA, DWI, LAVA , and T1WI sequences. Con ventional scan on transverse plane, sagittal plane of the uterus, and coronal plane of the pregnant women were performed. The corn parison between the prenatal MRI representation and the surgical results were also conducted. Results Placental abnormality was observed in forty-one pregnant women. The abnormality included 1 eases of placenta adhesion, 30 cases of praevia placenta, 31 cases of placental invasion, 3 cases of ablatio placentae with hematoma, and 1 case of placental hemorrhage. The praevia placenta also in- eluded 5 cases of low implantation of placenta, 4 cases of marginal previa placenta, 6 cases of partial previa placenta, and 15 cases of total previa placenta. The ablatio placentae and hematoma contained 2 cases of dorsal placental detachment and 1 case of dorsal and under arnniotic ablatio placentae with hematoma. Thirty five prenatal placental abnormalities just were observed from ultrasound ex amination. Conclusion MRI is greatly valuable for the diagnosis of prenatal placental abnormality to advanced pregnant women.