磁共振弥散加权成像在前置胎盘并发胎盘植入诊断中的准确率研究

The accuracy of diffusion-weighted magnetic resonance imaging in the diagnosis of placenta previa complicated with placental implantation

目的分析磁共振弥散加权成像(DWI)在前置胎盘并发胎盘植入诊断中的准确率。方法选定濮阳市妇幼保健院2020年10月至2023年10月就诊的86例经临床产检怀疑的前置胎盘并发胎盘植入患者,均给予DWI检查,将手术及病理诊断结果作为的金标准,分析DWI诊断效能,Kappa检验DWI与金标准的一致性,比较前置胎盘并发胎盘植入中植入部分与非植入部分表观弥散系数(ADC)值。结果手术及病理诊断前置胎盘并发胎盘植入81例。DWI确诊前置胎盘并发胎盘植入78例,包括穿透型23例、植入型25例、粘连型30例;诊断准确率是95.4%(82/86),灵敏度是96.3%(78/89),特异度是80.0%(4/5),Kappa检验DWI与金标准的一致性较好(Kappa值=0.786)(P<0.01)。前置胎盘并发胎盘植入中植入部分ADC值较非植入部分ADC值更高(P<0.01)。结论DWI可提高前置胎盘并发胎盘植入诊断准确率、灵敏度,与手术及病理诊断结果的一致性较好,通过定量检测ADC值可对其进行量化评估,在病情诊断中发挥着重要作用。

Objective To analyze the accuracy of diffusion-weighted magnetic resonance imaging(DWI)in the diagnosis of placenta previa complicated with placental implantation.Methods Eighty-six patients with suspected placenta previa complicated with placental implantation who underwent clinical prenatal examination and were treated at Puyang Maternal and Child Health Hospital in Henan Province from October 2020 to October 2023 were selected for DWI examination.The surgical and pathological diagnosis results were used as the gold standard for this study,and the diagnostic efficacy of DWI was analyzed,Kappa test for consistency between DWI and gold standard,comparing the apparent diffusion coefficient(ADC)values of the implanted and non implanted parts in placenta previa complicated with placental implantation.Results DWI confirmed 78 cases of placenta previa complicated with placental implantation,including 23 cases of penetrating type,25 cases of implantable type,and 30 cases of adhesive type.The diagnostic accuracy was 95.4%(75/86),sensitivity was 96.3%(78/81),and specificity was 80.0%(4/5),The Kappa test showed good consistency between DWI and the gold standard(Kappa=0.786)(P<0.01).The ADC value in the implanted part of placenta previa complicated with placental implantation is higher than that in the non implanted part(P<0.05).Conclusion DWI can improve the diagnostic accuracy and sensitivity of placenta previa complicated with placental implantation,and has good consistency with surgical and pathological diagnostic results.Quantitative detection of ADC values can be used for quantitative evaluation,playing an important role in disease diagnosis.