产后胎盘残留MRI诊断的价值

MRI in the diagnosis of postpartum placenta residue

目的 探讨MRI在产后胎盘残留诊断中的应用价值。方法 选取21例经病理证实的产后胎盘残留患者,比较其增强MRI及超声检查结果,分析MRI在产后胎盘残留诊断中的应用价值。结果 21例胎盘残留患者,3例为单纯胎盘残留,4例为胎盘粘连,11例为胎盘非穿透性植入,3例为胎盘穿透性植入。MRI及超声检查对胎盘残留诊断准确度均为100%(21/21)。MRI对单纯胎盘残留、胎盘粘连、非穿透性植入及穿透性植入的诊断敏感度为100.0%、75.0%、90.9%、66.7%,特异度为94.4%、94.1%、90.0%,100.0%,阳性预测值为75.0%、75.0%、90.9%,100.0%,阴性预测值为100.0%、94.1%、90.0%,94.7%。超声检查对上述类型的诊断敏感度为66.7%、50.0%、72.7%、66.7%,特异度为83.3%、88.2%、90.0%,94.4%,阳性预测值为40.0%、50.0%、88.9%,66.7%,阴性预测值为93.7%、88.2%、75.0%,94.4%。结论 MRI能准确评价胎盘产后残留的类型、植入深度等,在产后胎盘残留诊断中具有明显优势,为临床进一步治疗提供有效信息。

Objective To evaluate the application value of MRI in the diagnosis of postpartum placenta residue. Methods Twenty one patients with postpartum placenta residue confirmed by pathological result were collected in this study. The application value of MRI in the diagnosis of puerperal placenta residue was analyzed by comparison of enhanced MRI and Ultrasound results. Results Of the 21 cases, 3 cases were pure placental residue, 4 cases were placental adhesion, 11 cases were placental non-penetrating implantation, and 3 cases were placental penetrating implantation. The accuracy of MRI and Ultrasound was both 100%(21/21). The sensitivity of MRI in diagnosis of pure placental residue, placental adhesion, placental non-penetrating implantation and penetrating implantation was 100.0%, 75.0%, 90.9%, 66.7%, the specificity was 94.4%, 94.1%, 90.0%, 100.0%, the positive predictive value was 75.0%, 75.0%, 90.9%, 100.0%, the negative predictive value was 100.0%, 94.1%, 90.0%, 94.7%, while, corresponding types for Ultrasound, The sensitivity was 66.7%, 50.0%, 72.7%, 66.7%, the specificity was 83.3%, 88.2%, 90.0%, 94.4%, the positive predictive value was 40.0%, 50.0%, 88.9%, 66.7%, the negative predictive value was 93.7%, 88.2%, 75.0%, 94.4%. Conclusion MRI can accurately diagnose the category and depth of placenta puerperal residue. It is a valuable examination in the diagnosis of placenta puerperal residue and an effective supplement for clinical treatment.