产前彩超与MRI成像对胎盘植入的诊断价值

Diagnostic Value of Color Doppler Ultrasound and MRI for Placenta Implantation before Delivery

目的研究胎盘植入产前使用彩色多普勒超声与磁共振成像(MRI)诊断价值。方法回顾性分析我院2014年7月至2019年2月收治疑似胎盘植入孕妇67例,产前均实施彩色多普勒超声与MRI检查。观察两组孕妇产前彩超与MRI成像对胎盘植入的检出率,并将检查结果与手术病理学结果进行对比,分析两种检查方式诊断一致性及诊断效能。结果 67例患者经手术病理学检查胎盘植入41例(61.19%),其中产前彩超确诊31例(46.26%),MRI确诊35例(52.24%),两种检查方式检出率差异无统计学意义(P>0.05)。手术病理学检查前壁子宫37例,其中壁胎盘植入19例;后壁子宫30例,其中胎盘植入22例。两组检查结果对前壁胎盘植入检出率相当(P>0.05);MRI对后壁胎盘植入检出率优于彩超(P<0.05)。两种检查方式检查前壁胎盘植入特异度、准确率、阳性预测值、阴性预测值相当(P>0.05),MRI检查后壁胎盘植入灵敏度优于产前彩超(P<0.05),其中产前彩超与前壁胎盘植入病理学诊断结果具有一致性(Kappa>0.4),MRI与后壁胎盘植入病理学诊断结果一致性较好(Kappa>0.7)。结论产前彩超与MRI成像对胎盘植入均有一定诊断价值,且对前壁胎盘植入检出率相当,但MRI对后壁胎盘植入检出率优于产前彩超检查。

Objective To study the diagnostic value of color Doppler ultrasound and magnetic resonance imaging(MRI)for placenta implantation before delivery.Methods A retrospective analysis was performed on the 67 patients undergoing suspected placenta implantation admitted to the hospital from July 2014 to February 2019.Color Doppler ultrasound and MRI were performed on them before delivery.The detection rates of color Doppler ultrasound and MRI for placenta implantation before delivery in the two groups were observed.The examination results were compared with the surgical pathology results.The diagnostic consistency and diagnostic efficiency of the two examination methods were analyzed.Results Of the 67 patients,41 cases(61.19%)were undergoing placenta implantation examined by surgical pathology.There were 31 cases(46.26%)confirmed by prenatal color Doppler ultrasound,and 35 cases(52.24%)confirmed by MRI.There was no significant difference in detection rate between the two examination methods(P>0.05).There were 37 cases with the examination of the anterior wall uterus by surgical pathology,including 19 cases undergoing wall placenta implantation.There were 30 cases with the examination of the posterior wall uterus,including 22 cases undergoing placenta implantation.The detection rates of the two examination res ults we re comparable for anterior wall placenta implantation(P>0.05).The detection rate of MRI for posterior wall placenta implantation was better than that of color Doppler ultrasound(P<0.05).The specificity,accuracy,positive predictive value,and negative predictive value of the two examination methods for detecting anterior wall placenta implantation were comparable(P>0.05).The sensitivity of MRI for detecting posterior wall placenta impla ntation was better than that of prenatal color Doppler ult rasound(P<0.05).There was consistency between the prenatal color Doppler ultrasound and pathological diagnosis for anterior wall placenta impla ntation(Kappa>0.4).The consistency between MRI pathological diagnoses fo r posterior wall placenta impla ntation was good(Kappa>0.7).Conclusion There is a certain diagnostic value of prenatal color Doppler ultrasound and MRI for placenta implantation.The detection rates of the two for anterior wall placenta impla ntation a re equivalent.The detection rate of M RI for posterior wall placenta impla ntation is better than that of prenatal color Doppler ult rasound.