摘要
目的:研究探讨磁共振成像(magnetic resonance imaging,MRI)在胎盘植入中的临床诊断价值。方法:选择本院2017年1月-2018年12月就诊且怀疑为胎盘植入的80例妊娠晚期孕妇临床资料进行回顾性研究。所有孕妇均接受经阴道彩色多普勒超声检查及MRI检查,以分娩及术后的结果作为金标准。对比两种检查对胎盘植入诊断的特异度、灵敏度及其准确率。比较两种检查对不同类型胎盘植入的诊断符合率。并分析阴道超声和MRI与最终确诊结果之间的一致性。结果:80例怀疑胎盘胎盘植入的妊娠晚期孕产妇中,有50例经分娩或术后证实为胎盘植入,其中粘连性24例、植入性21例及穿透性5例。以分娩及术后结果为金标准,MRI对胎盘植入的诊断灵敏度、特异度、准确率均高于阴道超声(P<0.05)。MRI对粘连性与植入性胎盘植入的诊断符合率均高于阴道超声(P<0.05),而MRI与阴道超声对穿透性胎盘植入的诊断符合率比较,差异无统计学意义(P>0.05)。MRI与分娩及术后结果一致性明显高于阴道超声。结论:MRI对妊娠晚期孕产妇的胎盘植入可予以灵敏、准确检出,还可对其胎盘植入类型予以鉴别诊断,具有良好的诊断价值。
Objective:To study the clinical diagnostic value of magnetic resonance imaging(MRI)in placenta implantation.Method:Clinical data of 80 cases of pregnant women in the third trimester admitted to our hospital from January 2017 to December 2018 and suspected to be placental implantation were selected for retrospective study.All pregnant women underwent transvaginal color Doppler ultrasonography and MRI.The birth and postoperative results as the gold standard.The specificity,sensitivity and accuracy of the two different imaging examinations for placental implantation were compared.The diagnostic concordancy of the two examinations for different types of placenta implantation was compared.The consistency between transvaginal ultrasound,MRI and the final diagnosis was analyzed.Result:Among the 80 cases of women with suspected placental implantation in the third trimester of pregnancy,50 cases were confirmed as placental implantation after delivery or operation,included 24 cases of adherent,21 cases of implantable and 5 cases of penetrating.The results of delivery and post-operation were taken as the gold standard,the diagnostic sensitivity,specificity and accuracy of MRI for placenta implantation were higher than those of transvaginal ultrasound(P<0.05).The diagnosis coincidence rate of MRI in diagnosis of adherent and implantable placenta implantation were higher than those of transvaginal ultrasound(P<0.05),but there was no significant difference between MRI and transvaginal ultrasound in diagnosis coincidence rate of penetrating placenta implantation(P>0.05).The consistency of MRI with delivery and postoperative outcomes was significantly higher than that of transvaginal ultrasound.Conclusion:MRI can be sensitive and accurate to detect placental implantation in the third trimester of pregnancy.It can also be used to differentiate and diagnose the type of placental implantation,it has good diagnostic value.
作者
张永婕
ZHANG Yongjie(Fuzhou First Hospital Affiliated to Fujian Medical University,Fuzhou 350009,China)
出处
《中国医学创新》
CAS
2019年第33期157-160,共4页
Medical Innovation of China
关键词
胎盘植入
磁共振成像
经阴道彩色多普勒超声
Placenta implantation
Magnetic resonance imaging
Transvaginal color Doppler ultrasound
