MRI与彩色多普勒超声检查在妊娠晚期子宫后壁前置胎盘中的诊断价值

Comparison of MRI and Color Doppler Ultrasonography in the Diagnosis of Placenta Previa in the Posterior Wall of Late Pregnancy

[目的]探讨M RI与彩色多普勒超声检查在妊娠晚期子宫后壁前置胎盘中的诊断价值.[方法]回顾性分析2015年2月至2017年2月在本院诊治的妊娠晚期子宫后壁前置胎盘患者64例,术前均首选彩色多普勒超声技术进行检测,并针对疑似前置胎盘者在必要时可进M RI检测,并依据剖宫产手术结果作为病理诊断标准,评估两种检测方式的诊断准确性.[结果]全部患者均通过手术病理证实,64例前置胎盘中,中央型35例(54 .69%),部分型9例(14 .06%),边缘型11例(17 .19%),低置型9例(14 .06%);M RI技术诊断妊娠晚期子宫后壁前置胎盘准确率为98 .44%,仅出现1例误诊,将部分型误诊为中央型;彩色多普勒超声诊断准确率为95 .31%,出现3例误诊,其中将2例边缘型误诊为中央型,1例部分型误诊为中央型;M RI诊断妊娠晚期子宫后壁前置胎盘准确率略高于彩色多普勒超声,但差异有统计学意义( P >0 .05).[结论]临床诊断妊娠晚期子宫后壁前置胎盘首选彩色多普勒超声技术进行检测,并针对疑似前置胎盘者在必要时可进M RI检测,两种诊断技术对妊娠晚期子宫后壁前置胎盘诊断均有较高的准确率.

[Objective]To explore the diagnostic value of M RI and color Doppler ultrasonography in pla‐centa previa posterior wall of uterus in late pregnancy .[M ethods]A retrospective analysis was made of 64 cases of placenta previa on the posterior wall of the uterus in late pregnancy from February 2015 to February 2017 . Color Doppler ultrasonography was the first choice before operation .For suspected placenta previa patients , the results of cesarean section were used as pathological diagnostic criteria and the diagnostic accuracy of two kinds of detection was evaluated .[Results]All the patients were confirmed by surgery and pathology .Among the 64 cases of placenta previa ,35 (54 .69%) cases were of central type ,9 (14 .06%) cases were of partial type ,11 (17 .19%) cases were of marginal type ,and 9 (14 .06%) cases were of low type .T he accuracy of M RI in the diagnosis of placenta previa in the posterior wall of the uterus in the third trimester was 98 .44%,and only 1 case was misdiagnosed ,that is ,partial misdiagnosis was central type .T he diagnostic accuracy of color doppler ultrasound was 95 .31%,and 3 cases were misdiagnosed ,among which 2 cases were borderline misdi‐agnosed as central type and 1 case was partially misdiagnosed as central type .T he accuracy of M RI in the diagnosis of placenta previa in the posterior wall of the uterus in the third trimester was slightly higher than that of color doppler ultrasound ,but the difference was statistically significant ( P >0 .05).[Conclusion]In the clinical diagnosis of placenta previa via the posterior wall of the uterus in the third trimester of pregnancy ,color doppler ultrasound is the first choice for detection ,and M RI can be performed for those suspected of placenta previa w hen necessary .T he two diagnostic techniques have high accuracy in the diagnosis of placenta previa via the posterior wall of the uterus in the third trimester of pregnancy .