血清HCG、AFP水平联合MRI在前置胎盘植入及其分类诊断中的应用
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摘要
目的探讨血清人绒毛膜促性腺激素(HCG)、甲胎蛋白(AFP)水平联合磁共振成像(MRI)在前置胎盘植入及其分类诊断中的应用。方法选择我院收治的65例前置胎盘植入患者为前置胎盘植入组,另选择同期收治的60例单纯前置胎盘患者为单纯前置胎盘组,50例无前置胎盘无植入产妇为对照组,三组产妇产前均进行血清HCG、AFP与MRI检查,比较不同检查方法对前置胎盘植入及其分类诊断结果。结果前置胎盘植入组血清HCG、AFP水平均显著高于单纯前置胎盘组和对照组(P<0.05)。穿透型患者血清HCG、AFP水平均显著高于粘连型和植入型(P<0.05),植入型患者血清HCG水平显著高于粘连型(P<0.05)。HCG+AFP+MRI对粘连型胎盘植入检出率为96.55%,对植入型胎盘植入检出率为95.65%,对穿透型胎盘植入检出率为100%,均高于单纯血清HCG、AFP和MRI检测。结论血清HCG、AFP联合MRI可明确前置胎盘植入及胎盘植入类型,临床应用价值较高。
Objective To investigate the application of levels of serum human chorionic gonadotropin(HCG) and alpha fetoprotein(AFP) combined with magnetic resonance imaging(MRI) in implantation and classification diagnosis of placenta previa. Methods65 patients with placenta previa implantation in the hospital were enrolled in the placenta previa implantation group. The other 60 patients with single placenta previa in the same period were enrolled in the single placenta previa group. 50 parturients without placenta previa or implantation were enrolled in the control group. The serum HCG, AFP and MRI examination were performed on parturients in the three groups. The results of placenta previa implantation and classification diagnosis with different examination methods were compared. Results The levels of serum HCG and AFP in the placenta previa implantation group were significantly higher than those in the single placenta previa group and the control group(P<0.05). The levels of serum HCG and AFP in the penetrating patients were significantly higher than those in the adhesion type and implanted type patients(P<0.05). The serum HCG level of the implanted patients was significantly higher than that of the adhesion type patients(P<0.05). The implantation detection rates of adhesion placenta, implanted placenta and penetrating placenta with HCG with AFP and MRI were 96.55%, 95.65% and 100%, respectively, all higher than those with either of the three. Conclusion Serum HCG, AFP combined with MRI can identify the placenta previa implantation and type of placenta implantation.
Objective To investigate the application of levels of serum human chorionic gonadotropin(HCG) and alpha fetoprotein(AFP) combined with magnetic resonance imaging(MRI) in implantation and classification diagnosis of placenta previa. Methods65 patients with placenta previa implantation in the hospital were enrolled in the placenta previa implantation group. The other 60 patients with single placenta previa in the same period were enrolled in the single placenta previa group. 50 parturients without placenta previa or implantation were enrolled in the control group. The serum HCG, AFP and MRI examination were performed on parturients in the three groups. The results of placenta previa implantation and classification diagnosis with different examination methods were compared. Results The levels of serum HCG and AFP in the placenta previa implantation group were significantly higher than those in the single placenta previa group and the control group(P<0.05). The levels of serum HCG and AFP in the penetrating patients were significantly higher than those in the adhesion type and implanted type patients(P<0.05). The serum HCG level of the implanted patients was significantly higher than that of the adhesion type patients(P<0.05). The implantation detection rates of adhesion placenta, implanted placenta and penetrating placenta with HCG with AFP and MRI were 96.55%, 95.65% and 100%, respectively, all higher than those with either of the three. Conclusion Serum HCG, AFP combined with MRI can identify the placenta previa implantation and type of placenta implantation.
引文
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[13]Vojtech J,Pock R,Haslik L,et al.OP 17.09:Placenta praevia after previous Caesarean section risk stratification:ultrasound versus MRI[J]. Ultrasound in Obstetrics and Gynecology,2014,44(S 1):1.
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[2]黄蓓,李映桃,陈敦金,等.膀胱镜下双J管逆行插管在凶险型前置胎盘并植入患者术前的应用[J].实用医学杂志,2014, 30(14):2346-2347.
[3]王连云,谢爱兰,陈伟,等.产前超声与低场磁共振检查在胎盘植入诊断中的价值[J].中国临床医学影像杂志,2015,26(7):505-508.
[4]石慧,全显跃,孙希杰.产前胎盘植入的MRI诊断[J].中国医学影像学杂志,2015, 23(6):474-477.
[5]杜金超,吕富荣,肖智博,等.产前MRI特征性征象诊断胎盘植入[J].中国医学影像技术,2 01 8, 34(3):4 1 2-415.
[6]陈丹,马小燕.三维能量多普勒超声产前诊断胎盘植入的研究进展[J].中国医学影像学杂志,2014, 22(9):718-720.
[7]王光彬.MRI在凶险性前置胎盘诊断中的价值[J].山东大学学报:医学版,2016,54(9):7-9.
[8]韩鹏慧,江魁明,郭庆禄,等.超声及MRI在胎盘植入中的诊断价值[J].中国临床医学影像杂志,2016, 27(3):194-197.
[9]孟雷,李艳彬,许崇永,等.彩色多普勒超声联合核磁共振成像诊断胎盘植入的价值分析[J].中国计划生育学杂志,2018,26(2):140-142.
[10]韩倩,吴晓兰,李英,等.血清HCG,AFP联合超声检查对前置胎盘植入类型的相关性分析[J].现代生物医学进展,2016,16(29):5739-5741.
[11]金日男,许红雁,钟永红,等.血清甲胎蛋白联合彩色超声检查在胎盘植入产前诊断中的价值[J].现代妇产科进展,2016,25(8):611-613.
[12]官晓晖,马隆佰,韩武.胎盘植入的MRI诊断[J].中国CT和MRI杂志,2014,12(2):80-83.
[13]Vojtech J,Pock R,Haslik L,et al.OP 17.09:Placenta praevia after previous Caesarean section risk stratification:ultrasound versus MRI[J]. Ultrasound in Obstetrics and Gynecology,2014,44(S 1):1.
[14]Rademan K,Geerts L.EP15.04:Developing expertise in diagnosis of abnormally invasive placenta:a comparison of MRI and ultrasound assessment with surgery or histology findings[J]. Ultrasound in Obstetrics&Gynecology,2017,50(S1):328-328.