MRI检查对于胎盘植入及其植入深度的诊断价值

The Diagnostic Value of MRI for Placenta Implantation and Its Implantation Depth

目的探究MRI技术在产前诊断胎盘植入及其植入深度中的诊断价值。方法回顾性分析产前经妇产科及超声高度怀疑胎盘植入的43例患者的MRI检查资料,以手术及病理作为“金标准”,分析胎盘植入患者的MRI表现,并采用Kappa检验验证MRI诊断结果与“金标准”的一致性。结果43例疑诊患者经手术及病理证实全部为胎盘植入,其中4例可见局部胎盘组织与肌层分界面模糊,低信号肌层带不连续;39例可见子宫胎盘结合面低信号中断;17例可见子宫局部膨隆。MRI对其3种分类(粘连性、植入性、穿透性)诊断的敏感度分别为60.0%、88.9%、80.0%;特异度分别为94.7%、76.0%、100.0%;Kappa值分别为0.575、0.629、0.811。结论产前MRI检查在判断胎盘植入及其植入深度的诊断中准确度较高,对临床诊断有一定的参考价值。

Objective To explore the diagnostic value of MRI imaging in prenatal diagnosis of placenta implantation and its implantation depth.Methods The MRI examination data of 43 patients with highly suspected placental implantation through prenatal obstetrics and gynecology and ultrasound were retrospectively analyzed.The MRI findings of patients with placental implantation were analyzed using surgery and pathology as the“gold standard”.The consistency between MRI diagnosis and"gold standard"was verified by the Kappa test.Results All the 43 suspected patients were confirmed by surgery and pathology to have placenta implantation.In 4 cases,the boundary between local placenta tissue and muscular was blurred,and the muscular band with low signal was discontinuous.Low signal interruption at the junction of uterus and placenta was observed in 39 cases.Local uterine distension was seen in 17 cases.The sensitivity of MRI to the three classifications(adhesion,implantation,and penetration)was 60.0%,88.9%,and 80.0%,respectively.The specificity was 94.7%,76.0%,and 100.0%,respectively.Kappa values were 0.575,0.629,and 0.811,respectively.Conclusion Prenatal MRI has high accuracy in the diagnosis of placenta implantation and its implantation depth,which can provide a good basis for clinical diagnosis.