MRI检查对产前胎盘植入临床评估效果
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摘要
目的:探讨MRI检查对产前胎盘植入临床评估效果。方法:回顾性分析了2015年3月—2017年8月期间31例可疑胎盘植入的孕妇,并经手术证实胎盘植入的有关资料,对MRI表现进行评估,总结其MRI的图像特点及诊断价值。结果:MRI检查诊断产前胎盘的灵敏度达93.10%,特异度达50%,诊断的阳性预测率达96.43%,诊断的阴性预测率达66.67%,本组28例胎盘植入患者观察到的MRI征象有:胎盘内T2WI低信号灶,胎盘与肌层交界面消失;局部胎盘血管影增多;子宫局限性轮廓外突;膀胱局部"帐篷征"或胎盘组织侵入盆腔其他组织,其中5例患者出现两个及以上征象。结论:MRI检查在胎盘植入临床诊断的价值较高,与术后组织病理结果类似,具有一定的临床推广价值。
Objective: To investigate the clinical evaluation of MRI on the prenatal placenta implantation. Methods: We retrospectively analyzed 31 pregnant women with suspicious placenta implantation from march to august 2016, those whom were confirmed by surgery of placenta increta relevant materials, and to summarize its image characteristics MRI performance and to evaluate the diagnostic value of MRI. Results: The diagnostic sensitivity magnetic resonance imaging(MRI) for prenatal placenta implantation was 93.10%, the specificity was 50%, the positive predictive rate was 96.43% and negative prediction rate was 66.67%, this group of 28 patients with placenta increta observe MRI manifestations are as follow: low signal range was in the placenta T2 WI, The layer between placenta and muscular was disappeared; Local placental blood vessels was increased; The circumscribed of the uterus was out line; Local "tent sign" of bladder or placental tissue invasion of other tissues of the pelvic cavity, 5 patients showed signs of 2 or more. Conclusion: The clinical diagnosis value of MRI placenta implantation is relatively high, which is similar to the results of surgical pathological diagnosis and has the promotion value in clinical practice.
Objective: To investigate the clinical evaluation of MRI on the prenatal placenta implantation. Methods: We retrospectively analyzed 31 pregnant women with suspicious placenta implantation from march to august 2016, those whom were confirmed by surgery of placenta increta relevant materials, and to summarize its image characteristics MRI performance and to evaluate the diagnostic value of MRI. Results: The diagnostic sensitivity magnetic resonance imaging(MRI) for prenatal placenta implantation was 93.10%, the specificity was 50%, the positive predictive rate was 96.43% and negative prediction rate was 66.67%, this group of 28 patients with placenta increta observe MRI manifestations are as follow: low signal range was in the placenta T2 WI, The layer between placenta and muscular was disappeared; Local placental blood vessels was increased; The circumscribed of the uterus was out line; Local "tent sign" of bladder or placental tissue invasion of other tissues of the pelvic cavity, 5 patients showed signs of 2 or more. Conclusion: The clinical diagnosis value of MRI placenta implantation is relatively high, which is similar to the results of surgical pathological diagnosis and has the promotion value in clinical practice.
引文
[1]董天发,吴美仙,陈永露,等.子宫内异位妊娠MRI表现及临床意义[J].南昌大学学报(医学版),2017,57(3):31-35.
[2]Bobek G,Stait-Gardner T,Surmon L,et al.PP084.Magnetic resonance imaging measurements of T2 relaxation times within contrasting regions of murine placenta is dependent upon blood flow[J].Pregnancy Hypertens,2012,2(3):286.
[3]左春洁,刘凯丽,刘艳梅,等.彩色多普勒超声与MRI在胎盘植入产前诊断中的对比研究[J].陕西医学杂志,2017,46(6):711-713.
[4]韦树长,陈文勇.磁共振弥散加权成像诊断胎盘植入的价值[J].医学综述,2017,23(9):1859-1862.
[5]Shetty MK,Dryden DK.Morbidly Adherent Placenta:Ultrasound Assessment and Supplemental Role of Magnetic Resonance Imaging[J].Semin Ultrasound CTMR,2015,36(4):324-31.
[6]黄苑铭,黄冬平,涂艳萍,等.剖宫产瘢痕妊娠与植入性胎盘关系的研究[J].中华医学超声杂志(电子版),2017,14(5):368-372.
[7]D'Antonio F,Iacovella C,PalaciosJaraquemada J,et al.Prenatal identification of invasive placentation using magnetic resonance imaging:systematic review and meta-analysis[J].Ultrasound Obstet Gynecol,2014,44(1):8-16.
[2]Bobek G,Stait-Gardner T,Surmon L,et al.PP084.Magnetic resonance imaging measurements of T2 relaxation times within contrasting regions of murine placenta is dependent upon blood flow[J].Pregnancy Hypertens,2012,2(3):286.
[3]左春洁,刘凯丽,刘艳梅,等.彩色多普勒超声与MRI在胎盘植入产前诊断中的对比研究[J].陕西医学杂志,2017,46(6):711-713.
[4]韦树长,陈文勇.磁共振弥散加权成像诊断胎盘植入的价值[J].医学综述,2017,23(9):1859-1862.
[5]Shetty MK,Dryden DK.Morbidly Adherent Placenta:Ultrasound Assessment and Supplemental Role of Magnetic Resonance Imaging[J].Semin Ultrasound CTMR,2015,36(4):324-31.
[6]黄苑铭,黄冬平,涂艳萍,等.剖宫产瘢痕妊娠与植入性胎盘关系的研究[J].中华医学超声杂志(电子版),2017,14(5):368-372.
[7]D'Antonio F,Iacovella C,PalaciosJaraquemada J,et al.Prenatal identification of invasive placentation using magnetic resonance imaging:systematic review and meta-analysis[J].Ultrasound Obstet Gynecol,2014,44(1):8-16.