磁共振成像应用于检测胎盘植入介入治疗

MRI Applied to Detect Interventional Treatment for Placental Adhesive Disorders

为了探讨磁共振成像(magnetic resonance imaging, MRI)在胎盘植入介入治疗中的诊断作用和为临床治疗提供依据,本研究选取30例于2012年6月至2015年12月间在我院进行介入治疗的胎盘植入患者作为研究对象,根据病理诊断标准,分析患者胎盘植入介入治疗前后的MRI检查结果。结果显示,粘连性胎盘的敏感性和特异性分别为77.5%和90.2%,植入性胎盘的敏感性和特异性分别为75.5%和87.7%,穿透性胎盘的敏感性和特异性分别为85%和100%。最好的预测胎盘植入的MRI特征是在T2W磁共振成像(T2W-MRI)序列上存在暗色的胎盘内条带。介入治疗1年后复查时,发现患者子宫恢复为正常大小,宫腔内的胎盘组织基本消失,宫壁与植入胎盘融合、宫腔内膜线和子宫结合带的信号完整。综上结果,说明MRI可作为检测胎盘植入可靠性和可重复性的工具,并且能够显示胎盘植入部位及子宫肌层受侵程度,可用于评价胎盘植入介入治疗的疗效。

In order to explore the diagnostic role of magnetic resonance imaging(MRI) in interventional treatment of placental adhesive disorders, and provide evidence for clinical treatment, 30 patients with placental adhesive disorders who underwent uterine artery chemoembolization were selected for interventional therapy in our hospital from June 2012 to December 2015 were selected as the research objects. The results of MRI examination before and after the treatment were analyzed according to the clinical diagnostic criteria. The results showed that the sensitivity and specificity of the adhesive placenta were 77.5% and 90.2%, respectively. The sensitivity and specificity of the implantable placenta were 75.5% and 87.7%, respectively. The sensitivity and specificity of the penetrating placenta were 85% and 100%. The best predictive MRI feature of placental implantation is the presence of dark intra-placental bands on the T2 W MRI sequence. After one year of interventional treatment, the patient’s uterus recovered to normal size,the placental tissue in the uterine cavity disappeared, and the signal of the uterine wall and the implanted placenta, the intrauterine line and the uterus were intact. In summary, MRI could be used as a tool to detect the reliability and reproducibility of placental implants, and could display the degree of invasion of the placenta accrete and the myometrium,which could be used to evaluate the efficacy of interventional treatment of placental adhesive disorders.