磁共振成像在妊娠期子宫嵌顿诊治中的应用探讨

Application of MRI in the Diagnosis and Treatment of Uterine Incarceration during Pregnancy

目的:探讨磁共振成像(magnetic resonance imaging,MRI)在妊娠期子宫嵌顿诊治中的应用价值。方法:回顾性分析2010—2020年于北京大学第三医院产科诊治的4例妊娠期子宫嵌顿病例,回顾MRI和超声检查对该病例诊断的经验和术前评估的价值。结果:2例初次超声提示完全性前置胎盘,2例超声提示宫颈及子宫下段回声杂乱,4例经MRI检查后明确诊断妊娠期子宫嵌顿,其中1例孕中期复位后自然分娩,1例因为合并胎盘植入孕中期终止妊娠,2例于孕晚期结合MRI图像制定围术期方案,母儿结局良好。结论:MRI能够对疑似妊娠期子宫嵌顿的病例进行明确诊断,同时可以指导制定手术方案。超声疑似子宫嵌顿病例应及时完善MRI明确诊断,有助于改善母儿结局。

Objective:To investigate the application of magnetic resonance imaging(MRI)in the diagnosis and treatment of uterine incarceration during pregnancy.Methods:Four cases of uterine incarceration during pregnancy treated in the Obstetrics Department of Peking University Third Hospital from 2010 to 2020 were retrospectively analyzed.MRI and ultrasound were used in the diagnosis of these cases,and the application value of MRI in preoperative evaluation were evaluated.Results:2 cases with placenta previa,and 2 cases with abnormal cervix and lower uterine segment,were found by the primary ultrasound.The definite diagnosis of 4 cases was made by MRI examination.The pregnancy outcomes were included 1 case with vaginal delivery at term after reset in the second trimester,1 case with cesarean section at mid-trimester because of placenta increta,and 2 cases with deliberated cesarean section at third-trimester.Conclusions:MRI can make a definite diagnosis for those suspected cases of uterine incarceration during pregnancy,as a reference for surgical plan.For ultrasound the suspected cases of uterine incarceration,the definite diagnosis by MRI will improve the outcomes of mother and child.