磁共振成像在胎盘植入诊断的应用研究

Application of magnetic resonance imaging in the diagnosis of placenta accrete

目的探讨胎盘植入的MRI征象及MRI对诊断胎盘植入的应用价值。方法回顾性分析自2012年10月-2016年12月就诊于我院并经手术证实为胎盘植入的22例患者的临床资料,患者术前均行常规MRI扫描,总结胎盘植入的图像特点,并通过统计学分析研究MRI对胎盘植入的诊断价值。结果胎盘植入的特异性MRI表现为胎盘与子宫肌层交界处间隙消失、分界不清,子宫肌层变薄、缺损,可见胎盘突入子宫肌层内的锯齿状影;胎盘信号不均匀,T2WI出现低信号条状影;胎盘内可见迂曲扩张的血管或血管团信号影。与手术及术后病理比较,MRI诊断胎盘植入的符合率约为86.4%(19/22),漏诊及误诊率约为13.6%(3/22),漏诊及误诊患者均为粘连性胎盘。结论 MRI检查对胎盘植入的诊断有较高的临床价值,可作为超声检查的重要补充检查手段,但其在粘连性胎盘的诊断方面仍需提高。

Objective To investigate the MRI signs of placenta implantation and the value of MRI in diagnosis of placenta implantation. Methods Clinical data of 22 patients hospitalized in our hospital from October 2012 to December 2016 were analyzed. ALl patients underwent conventional MRI scan before operation and the image characteristics of placenta implantation were summarized. The diagnostic value of MRI to placenta implantation was analyzed statistically. Results The specific MRI manifestations of placenta implantation were that the gap of junction between placenta and myometrium disappeared, the boundaries were unclear, grassroots uterus were thin and eoloboma, jagged image of placenta into the myometrial lining could be seen; Signal of placental was not uniform, and there were low signal bar shadow in T2WI; The placenta could be seen in the tortuous expansion of the blood vessels or blood vessels group signal shadow. The coincidence rate of MRI diagnosis for placenta implantation was 86.4% （ 19/22 ）, and misdiagnosis was 13.6% （3/22）. Conclusion MRI examination of placenta implantation has high clinical value. It can be used as an important complement ultrasound examination, but in the diagnosis of adhesive placenta it is still needed to improve.