前置胎盘伴植入的MRI诊断
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摘要
目的:对核磁共振成像(MRI)诊断前置胎盘伴植入的临床价值进行评价。方法:将2015年3月至2018年3月科室收治的35例前置胎盘疑似伴胎盘植入的患者纳入本次研究,资料分析显示所有患者均接受彩色多普勒超声检查和MRI检查,对比两种不同诊断方法的结果,评价MRI诊断前置胎盘伴植入的价值。结果:术有10例患者胎盘自然剥离,无植入和粘连的情况。其余25例病理检查结果显示12例患者伴植入,其余13例患者仅为粘连。彩色多普勒超声诊断检查结果显示15例患者伴植入,经过病理检查对比,有3例患者仅为粘连,2例患者无植入,2例患者胎盘位于后壁。5例为误诊、2例漏诊;MRI诊断结果显示14例患者伴植入,病理对比结果显示3例患者为胎盘粘连,误诊3例、漏诊1例。两种检查方法的阳性检出率、误漏诊率以及与病理诊断结果的符合率均未见统计学差异,P>0.05。结论:MRI诊断前置胎盘伴植入具有较高的诊断准确性,与彩超诊断结果相近,临床中可与彩超检查相互结合,更好的保证诊断效果,为患者的治疗提供有价值的参考。
Objective: To evaluate the clinical value of magnetic resonance imaging(MRI) in the diagnosis of placenta previa with implantation. Methods: Thirty-five patients with suspected placenta previa placed in the department from March 2015 to March 2018 were included in the study. The data analysis showed that all patients underwent color Doppler ultrasonography and MRI. The results of two different diagnostic methods to evaluate the value of MRI in the diagnosis of placenta previa with implantation. Results: Ten patients had natural placental detachment without implantation and adhesion. The remaining 25 cases of pathological examination showed 12 patients with implantation,and the remaining 13 patients were only adhesions. The results of color Doppler ultrasound diagnostic examination showed that 15 patients were enrolled. After pathological examination,3 patients only had adhesions,2 patients had no implants,and 2 patients had placenta at the posterior wall. Five cases were misdiagnosed and 2 cases were missed. MRI diagnosis showed that 14 cases were implanted. The pathological comparison showed that 3 cases were placental adhesions,3 cases were misdiagnosed,and 1 case was missed. There was no statistical difference between the positive detection rate,misdiagnosis rate and the coincidence rate with pathological diagnosis results of the two examination methods,P > 0. 05. Conclusion: The MRI diagnosis of placenta previa with high diagnostic accuracy,similar to the results of color Doppler ultrasound diagnosis,combined with color Doppler ultrasound in clinical practice,better guarantee the diagnosis effect,and provide valuable reference for the patient's treatment.
Objective: To evaluate the clinical value of magnetic resonance imaging(MRI) in the diagnosis of placenta previa with implantation. Methods: Thirty-five patients with suspected placenta previa placed in the department from March 2015 to March 2018 were included in the study. The data analysis showed that all patients underwent color Doppler ultrasonography and MRI. The results of two different diagnostic methods to evaluate the value of MRI in the diagnosis of placenta previa with implantation. Results: Ten patients had natural placental detachment without implantation and adhesion. The remaining 25 cases of pathological examination showed 12 patients with implantation,and the remaining 13 patients were only adhesions. The results of color Doppler ultrasound diagnostic examination showed that 15 patients were enrolled. After pathological examination,3 patients only had adhesions,2 patients had no implants,and 2 patients had placenta at the posterior wall. Five cases were misdiagnosed and 2 cases were missed. MRI diagnosis showed that 14 cases were implanted. The pathological comparison showed that 3 cases were placental adhesions,3 cases were misdiagnosed,and 1 case was missed. There was no statistical difference between the positive detection rate,misdiagnosis rate and the coincidence rate with pathological diagnosis results of the two examination methods,P > 0. 05. Conclusion: The MRI diagnosis of placenta previa with high diagnostic accuracy,similar to the results of color Doppler ultrasound diagnosis,combined with color Doppler ultrasound in clinical practice,better guarantee the diagnosis effect,and provide valuable reference for the patient's treatment.
引文
1雷晓真,郑九生,黄淑晖,余诧,付群,余诧,夏劲,刘淮.超声连续追踪对凶险型前置胎盘伴胎盘植入的早期诊断价值[J].江西医药,2017,52(12):1275-1278.
2 姜子燕,葛志平,黄诗韵,郭晨燕,孙丽洲.彩超和核磁共振诊断完全性前置胎盘伴植入对比分析[J].南京医科大学学报(自然科学版),2017,37(01):88-89+92.
3 罗友,廖林,王小红,景卫,王智慧.超声与磁共振成像对凶险型前置胎盘伴胎盘植入的诊断比较[J].泸州医学院学报,2016,39(06):572-574.
4 于万芹,刘巧敏,谭书卓.凶险性前置胎盘伴胎盘植入的诊断与治疗[J].河北医药,2016,38(22):3485-3488.
5 陈凤英,张大伟,刘正平,王文,杨伟超,吴仁华.凶险型前置胎盘伴胎盘植入的产前MRI平扫影像学表现及诊断价值[J].中国临床医学影像杂志,2016,27(05):359-362.
6 华建军,蒋春景,朱碧莲,楼建义,范徐妃,郑秀娟,蒋晓春,丁明星.36例前置胎盘或伴胎盘植入的磁共振脂肪抑制T2加权成像评价[J].实用妇产科杂志,2015,31(07):535-539.
7 钟华,李丽红,代海洋,黎昕,刘锦文.前置胎盘合并胎盘植入的MRI产前诊断[J].磁共振成像,2014,5(06):463-466.
2 姜子燕,葛志平,黄诗韵,郭晨燕,孙丽洲.彩超和核磁共振诊断完全性前置胎盘伴植入对比分析[J].南京医科大学学报(自然科学版),2017,37(01):88-89+92.
3 罗友,廖林,王小红,景卫,王智慧.超声与磁共振成像对凶险型前置胎盘伴胎盘植入的诊断比较[J].泸州医学院学报,2016,39(06):572-574.
4 于万芹,刘巧敏,谭书卓.凶险性前置胎盘伴胎盘植入的诊断与治疗[J].河北医药,2016,38(22):3485-3488.
5 陈凤英,张大伟,刘正平,王文,杨伟超,吴仁华.凶险型前置胎盘伴胎盘植入的产前MRI平扫影像学表现及诊断价值[J].中国临床医学影像杂志,2016,27(05):359-362.
6 华建军,蒋春景,朱碧莲,楼建义,范徐妃,郑秀娟,蒋晓春,丁明星.36例前置胎盘或伴胎盘植入的磁共振脂肪抑制T2加权成像评价[J].实用妇产科杂志,2015,31(07):535-539.
7 钟华,李丽红,代海洋,黎昕,刘锦文.前置胎盘合并胎盘植入的MRI产前诊断[J].磁共振成像,2014,5(06):463-466.