MRI征象评分对胎盘种植异常的诊断价值

The value of score scale of MRI signs in diagnosis of placental implantation abnormalities

目的:探讨MRI征象评分对胎盘种植异常的诊断价值。方法:回顾性分析2017年6月-2019年3月在我院收治的疑似为胎盘种植异常的189例孕妇的临床和MRI资料,根据手术病理结果,将患者分为对照组及胎盘种植异常组,后者又分为粘连型和植入/穿透型两组,比较3组间MRI征象的差异,将组间差异有统计学意义的征象纳入评分表,建立改良MRI征象评分表,计算基于该评分表的诊断符合率,并绘制ROC曲线,确定基于改良MRI征象评分表诊断各型胎盘种植异常的截断值。结果:采用改良MRI征象评分表对胎盘种植异常的总体诊断符合率为89.9%、敏感度93.5%、特异度87.5%,阳性预测值为83.7%,阴性预测值为95.1%。根据ROC曲线,鉴别对照组及粘连型胎盘种植异常组的截断值为4分,而鉴别粘连型与植入/穿透型的截断值为8分。结论:改良MRI征象评分表对胎盘种植异常具有较高的诊断效能。

Objective:To explore the value of score scale of MRI signs in diagnosis of placental implantation.Methods:Clinical and MRI data of 189 pregnant women suspected of placental implantation abnormalities was retrospectively analyzed in our hospital from June 2017 to March 2019.Accor-ding to their clinical data,the patients were divided into control group and placental implantation group(including accreta and increta/percreta subgroup).The MRI signs with statistical significance were included and the improved MRI signs scoring scale was established,and its diagnostic accuracy for placental implantation was evaluated.Based on the ROC curve,the cut-off value for the differentiation of various types of placental implantation was determined.Results:Based on the score scale,the diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value for placental implantation were 89.9%,93.5%,87.5%,83.7%and 95.1%,respectively.ROC curve analysis showed that the cut-off value for differentiation of control group and accreta group was 4 scores,and for accreta group and increta/percreta group it was 8 scores.Conclusion:The score scale of MRI signs for placenta implantation abnormality is of high diagnostic efficacy.