MRI诊断凶险性前置胎盘合并胎盘植入的临床应用价值
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摘要
目的探究磁共振成像(MRI)对于诊断凶险性前置胎盘植入程度的临床应用价值。方法回顾性分析2016年1月—2018年6月,唐山市妇幼保健院收治住院并终止妊娠的71例凶险性前置胎盘且疑似胎盘植入患者。术前根据MRI图像对凶险性前置胎盘植入程度进行评估诊断,术后根据病理结果对其诊断的灵敏度及特异度进行评价。结果所有患者术前均为凶险性前置胎盘,其中MRI诊断正确的有33例植入型,15例非植入型,术后病理证实植入型46例,非植入型25例,MRI对凶险性前置胎盘合并胎盘植入的诊断的灵敏度为71.74%,特异度为60.00%。结论对于凶险性前置胎盘疑似合并胎盘植入患者,产前通过MRI检查,充分发挥此项检查受孕妇体型影响小、不受胎盘位置影响、组织分辨率高等优点,正确评估胎盘植入程度。
Objective To explore the clinical value of magnetic resonance imaging(MRI) in the diagnosis of pernicious placenta previa implantation.Methods Retrospective analysis was made on seventy-one cases of pernicious placenta previa with suspected placenta implantation admitted to Tangshan Maternal and Child Health Hospital from January 2016 to June 2018. The degree of dangerous placenta previa implantation was assessed and diagnosed by MRI images before operation,and the sensitivity and specificity of diagnosis were evaluated by pathological results after operation.Results All patients were pernicious placenta previa before operation,of which 33 cases were implantable and 15 cases were non-implantable.Postoperative pathology confirmed that 46 cases were implantable and 25 cases were non-implantable,the sensitivity and specificity of MRI in the diagnosis of pernicious placenta previa complicated with placenta implantation were 71.74% and 60.00%,respectively.Conclusion For the patients suspected of pernicious placenta previa complicated with placenta implantation,prenatal MRI examination can give full play to the advantages of small size of pregnant women,not affected by placenta position,high tissue resolution,and accurately evaluate the degree of placenta implantation.
Objective To explore the clinical value of magnetic resonance imaging(MRI) in the diagnosis of pernicious placenta previa implantation.Methods Retrospective analysis was made on seventy-one cases of pernicious placenta previa with suspected placenta implantation admitted to Tangshan Maternal and Child Health Hospital from January 2016 to June 2018. The degree of dangerous placenta previa implantation was assessed and diagnosed by MRI images before operation,and the sensitivity and specificity of diagnosis were evaluated by pathological results after operation.Results All patients were pernicious placenta previa before operation,of which 33 cases were implantable and 15 cases were non-implantable.Postoperative pathology confirmed that 46 cases were implantable and 25 cases were non-implantable,the sensitivity and specificity of MRI in the diagnosis of pernicious placenta previa complicated with placenta implantation were 71.74% and 60.00%,respectively.Conclusion For the patients suspected of pernicious placenta previa complicated with placenta implantation,prenatal MRI examination can give full play to the advantages of small size of pregnant women,not affected by placenta position,high tissue resolution,and accurately evaluate the degree of placenta implantation.
引文
[1] 张惠,张又红,佘玲娜,等.凶险性前置胎盘的超声分析[J].中国现代药物应用,2018,12(13):62-63
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[19] 蒋瑜,杨太珠,罗红,等.超声与MRI产前诊断凶险性前置胎盘的临床意义[J].中国超声医学杂志,2016,32(4):349-351
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[22] 季淑英,姬明杰,李桂荣,等.凶险型前置胎盘65例临床分析[J].中国煤炭工业医学杂志,2014,17(9):1412-1415
[23] 刘静,郝丽英.凶险性前置胎盘诊治研究进展[J].中国医药,2018,13(1):158-160
[2] 陈雅暖.凶险性前置胎盘90例临床分析[D].吉林大学,2017
[3] 王永莉,刘燕,张丽平,等.彩色多普勒超声在胎盘植入诊断中的应用[J].中国煤炭工业医学杂志,2013,16(1):37-39
[4] 王琳,唐龙珍,汪佳,等.胎盘植入41例临床分析[J].中国煤炭工业医学杂志,2012,15(11):1751-1752
[5] 符式新,张茜,张凯钟,等.磁共振成像对凶险性前置胎盘的诊断价值分析[J].中国计划生育和妇产科,2018,10(6):64-67
[6] 张勤,马腾,陆娴,等.胎盘植入的MRI诊断[J].中国医学计算机成像杂志,2015,21(6):561-565
[7] 李黎,高芬,蔡萍,等.产前MRI与超声对凶险性前置胎盘伴胎盘植入的诊断价值[J].中国产前诊断杂志(电子版),2018,10(1):34-37
[8] 周碧华,郑笑娟,徐建,等.产前超声与磁共振对胎盘植入的诊断价值[J].中国计划生育学杂志,2016,24 (1):36-38
[9] 付晨薇,刘俊涛,杨剑秋,等.前置胎盘所致产后出血病例分析[J].生殖医学杂志,2014,23(3):224-228
[10] 李琴,邓学东,王中阳,等.凶险型前置胎盘合并胎盘植入的产前超声诊断分析[J].中华医学超声杂志(电子版),2016,13(3):218-223
[11] McMahon K,Karumanchi SA,Stillman IE,et al.Does soluble fms-like tyrosine kinase-1 regulate placental invasion?Insight from the invasive placenta[J].Am J Obstet Gynecol,2014,210(1):1-4
[12] 邢秋丽.凶险性前置胎盘并发胎盘植入的临床分析[J].河南外科学杂志,2015,21(6):46-47
[13] Cho HY,Hwang HS,Jung I,et al.Diagnosis of placenta accreta by uterine artery doppler velocimetry in patients with placenta previa[J].J Ultrasound Med,2015,34(9):1571
[14] 李晴,杨茵,葛榕,等.孕晚期凶险型前置胎盘30 刮临床分析[J].山西医科大学学报,2013,44(6):471-475
[15] Daney de Marcillac F,Lecointre L,Guillaume A,et al.Maternal morbidity and mortality associated with conservative management for placenta morbidly adherent (accreta) diagnosed during pregnancy.Report of 15 cases[J].J Gynecol Obstet Biol Reprod(Paris),2016,45(8):849-858
[16] Malagón Reyes RM,Castorena vila R.Sclerotherapy with 6% polidocanol solution in patients with placenta accreta[J].Taiwan J Obstet Gynecol,2016,55(5):654-658
[17] 孙多成,肖忠,蔡春芳.低场MRI在胎盘植入诊断中的应用[J].中国妇幼保健,2013,28(29):4879-4881
[18] 赵毅,万军.MRI检查胎盘植入高危患者的结果分析及影像学表现[J].中国CT和MRI杂志,2018,16(3):93-96
[19] 蒋瑜,杨太珠,罗红,等.超声与MRI产前诊断凶险性前置胎盘的临床意义[J].中国超声医学杂志,2016,32(4):349-351
[20] 李红.MRI在胎盘植入中应用研究[J].中国CT和MRI杂志,2017,15(6):128-130
[21] 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
[22] 季淑英,姬明杰,李桂荣,等.凶险型前置胎盘65例临床分析[J].中国煤炭工业医学杂志,2014,17(9):1412-1415
[23] 刘静,郝丽英.凶险性前置胎盘诊治研究进展[J].中国医药,2018,13(1):158-160