三维超声联合MRI快速成像序列在妊娠晚期胎盘植入分级诊断中的应用价值

Application Value of Three-Dimensional Ultrasound Combined with MRI Rapid Imaging Sequence in the Grading Diagnosis of Placental Implantation in Late Pregnancy

目的探讨三维超声联合MRI快速成像序列在妊娠晚期胎盘植入分级诊断中的应用价值。方法选取2019年8月至2022年5月我院收治的84例胎盘植入孕妇,均行三维超声、MRI快速成像序列检查。以术中探查及产后胎盘病理检查结果作为“金标准”,采用κ一致性检验法评估三维超声联合MRI快速成像序列对妊娠晚期胎盘植入分级的诊断效能。结果术中探查及产后病理检查结果显示,84例胎盘植入孕妇中粘连性43例、植入性30例、穿透性11例。以术中探查及病理诊断结果作为“金标准”,三维超声联合MRI快速成像序列诊断妊娠晚期胎盘植入分级的准确度为97.62%,高于三维超声的82.14%及MRI快速成像序列的84.52%(P<0.05),且三维超声联合MRI快速成像序列与术中探查及产后病理检查结果的一致性良好(κ=0.782,P<0.05)。结论三维超声联合MRI快速成像序列在妊娠晚期胎盘植入分级中的诊断价值较高,值得临床推广应用。

Objective To explore the application value of three-dimensional ultrasound combined with MRI rapid imaging sequence in the grading diagnosis of placental implantation in late pregnancy.Methods 84 pregnant women with placental implantation admitted to our hospital from August 2019 to May 2022 were selected and given three-dimensional ultrasound and MRI rapid imaging sequence.Taking the results of intraoperative exploration and postpartum placental pathology as the gold standard,k consistency test was used to evaluate the diagnostic efficacy of three-dimensional ultrasound combined with MRI rapid imaging sequence in the grading of placental implantation in late pregnancy.Results The results of intraoperative exploration and postpartum pathological examination showed that there were 43 cases of adhesion,30 cases of implantation and 11 cases of penetration in 84 pregnant women with placenta implantation.Taking the results of intraoperative exploration and postpartum placental pathology as the gold standard,the accuracy of three-dimensional ultrasound combined with MRI rapid imaging sequence in the grading diagnosis of placental implantation in late pregnancy was 97.62%,higher than 82.14%of three-dimensional ultrasound or 84.52%of MRI rapid imaging sequence(P<0.05).Three-dimensional ultrasound combined with MRI rapid imaging sequence had good consistency with intraoperative exploration and postpartum pathological examination(κ=0.782,P<0.05).Conclusions Three dimensional ultrasound combined with MRI rapid imaging sequence has higher diagnostic value in the late pregnancy placental implantation grading,which is worthy of clinical promotion and application.