妊娠期胎盘植入MRI的诊断评价及植入范围分级的临床意义分析

Diagnostic Evaluation of Pregnancy Placenta Implantation MRI and Clinical Significance of Implantation Range Classification

目的:探讨妊娠期胎盘植入MRI的诊断评价及植入范围分级的临床应用价值。方法:选取2016年1月1日—2017年1月1日我院经超声检查疑似出现妊娠期胎盘植入的20例产妇,进行MRI检查,最终标准以手术病理证实为准,针对产妇MRI图像进行回顾性分析,探讨检查结果的特征以及诊断价值。结果:MRI图像征象显示对判断肌层侵入情况灵敏度、阴性预测率最高,然后是子宫肌层渐行变薄,T2WI胎盘内低信号带的观察较为敏感,有较高的预测率,横断面图像中子宫外突的特异度以及阳性预测率最高。根据植入范围MR分级,对A级患者采取常规保守治疗治愈率为100%;对B级患者进行保守治疗治愈率25.00%(1/4),对C级患者进行保守治疗成功率16.67%(1/6)。纳入统计学分析有明显差异(P<0.05)。结论:MR分级在治疗妊娠期胎盘植入有重要的指导意义。MRI在诊断妊娠期胎盘植入方面具有突出优势,横断图显示胎盘到肌层交界面消失,可作为判断妊娠期胎盘植入的诊断依据。

Objective To evaluate the clinical value of placenta accreta in the diagnosis and evaluation of implantation range. Methods From January 1, 2016 to January 1, 2017, 20 cases of pregnant women with placental implantation during pregnancy were examined by ultrasonography. The images were analyzed retrospectively to explore the characteristics of the test results and the diagnostic value. According to the MRI cross-sectional map, the placenta showed the maximum range of the incidence of maternal MR grade, C grade for the cross-sectional map showed serosal invasion. Class B: Implant> 50%.Class A: implanted surface ≤ 50%. The success rate of chi-square test was determined after the diagnosis of maternal grade.Results MRI images showed the sensitivity and negative predictive rate of myometrial invasion, and then the myometrial myometrium became thinner, and the observation of low signal band in T2 WI placenta was more sensitive, with higher prediction rate, cross-sectional image The specificity of the uterine extrauterine and the highest positive predictive rate.According to the implantation range MR grade, the cure rate of conventional conservative treatment was 100% for patients with grade A; the cure rate was 25.00%(1/4) for grade B patients and 16.67% for conservative treatment of grade C patients1/6). There was significant difference between the two groups(P<0.05). Conclusion MR grade plays an important role in the treatment of placenta previa during pregnancy. cross-sectional map shows placenta to muscle interface disappeared for the diagnosis of placenta previa pregnancy to provide the most accurate diagnostic basis.