摘要
目的探讨产前超声和磁共振检查在胎盘植入诊断中的应用价值。方法选取赣州市人民医院2016年4月～2018年8月期间产前检查疑似胎盘植入的74例患者,所有患者均采取彩超检查和磁共振检查,并与病理学结果对比,分析产前超声及磁共振检查在胎盘植入诊断中的灵敏度、特异度以及符合率。结果 74例患者经手术病理确诊胎盘植入45例,其中40例合并前置胎盘。术前彩超诊断胎盘植入31例,其中3例经手术病理诊断排除。术前MRI诊断胎盘植入38例,其中2例经手术病理诊断排除。超声检查诊断检测胎盘植入的灵敏度为62.22%低于磁共振检查诊断检测的80.00%,差异有统计学意义(P<0.05)。超声检查诊断检测胎盘植入的特异度为89.66%,与磁共振检查的特异度93.10%比较,差异无统计学意义(P>0.05)。超声检查诊断检测胎盘植入的符合率72.97%,与磁共振检查符合率85.14%比较,差异无统计学意义(P>0.05)。结论超声是产前检查的常规项目,其费用低廉,是胎盘植入筛查的重要方法。而磁共振检查的灵敏度高于超声诊断,对于胎盘位于后壁或者存在多种高危因素但超声诊断阴性的患者,磁共振成像可作为其重要的补充检查方法,以减少胎盘植入的漏诊。
Objective To explore the application value of prenatal ultrasound and magnetic resonance imaging in the diagnosis of placenta implantation.Methods 74 patients with suspected placenta implantation in prenatal examination in our hospital from April 2016 to August 2018 were selected.All patients were given color Doppler ultrasonography and magnetic resonance imaging,and by comparing with the pathological results,the sensitivity,specificity and coincidence rate of prenatal ultrasound and magnetic resonance imaging in the diagnosis of placenta implantation were analyzed.Results Of the 74 patients,45 were diagnosed as placenta implantation by surgical pathology,and 40 of them were combined with placenta previa.31 patients were diagnosed as placenta implantation by preoperative color Doppler ultrasound,and 3 of them were excluded by surgical pathology.38 patients were diagnosed as placenta implantation by MRI,and 2 of them were excluded.The sensitivity of ultrasound examination was 62.22%,lower than the 80.00%of magnetic resonance,and the difference was statistically significant(P<0.05).The specificity of ultrasound was 89.66%,which was not significantly different from the specificity of magnetic resonance imaging(93.10%)(P>0.05).The coincidence rate of ultrasound examination was 72.97%,and the coincidence rate of magnetic resonance examination was 85.14%,and the difference was not statistically significant(P>0.05).Conclusion Ultrasound is a routine procedure for prenatal examination,which is inexpensive and an important method for screening for placenta implantation.The sensitivity of magnetic resonance imaging is higher than that of ultrasound diagnosis.For patients whose placenta is located in the posterior wall or where there are many high-risk factors but negative ultrasound results,magnetic resonance imaging can be used as an important supplementary examination method to reduce the missed diagnosis of placenta implantation.
作者
王琪
李夏芳
曾敏
徐敏娟
WANG Qi;LI Xiafang;ZENG Min;XU Minjuan(Department of Obstetrics,Ganzhou People's Hospital in Jiangxi Province,Ganzhou 341000,China)
出处
《中国现代医生》
2018年第35期124-127,共4页
China Modern Doctor
关键词
胎盘植入
多普勒超声
磁共振
诊断价值
Placenta implantation
Doppler ultrasound
Magnetic resonance
Diagnostic value
