摘要
目的探讨MRI间接征象评分预测胎盘植入类型的价值。资料与方法回顾性分析141例怀疑胎盘植入患者的临床及MRI资料。根据术中或病理结果,将患者分为正常组52例及异常组89例(包括粘连型62例、植入型17例、穿透型10例)。选择具有统计学差异的临床指标联合MRI间接征象(胎盘异质性、胎盘内/下纡曲增多血管、子宫下段膨隆等),制订评分表,并绘制受试者工作特征(ROC)曲线,确定各组MRI评分界值。结果两组患者流产次数、剖宫产次数以及合并前置胎盘方面比较,差异均有统计学意义(χ^(2)=28.007、19.915、17.163,P均<0.05);正常组评分低于异常组[(2.9±1.0)分比(5.2±1.8)分;t=16.645,P<0.05],粘连型评分低于植入型、穿透型[(4.5±1.5)分比(6.5±1.2)分及(7.3±1.3)分;F=25.676,P<0.05];ROC曲线显示,当曲线下面积为0.824、评分≥2.5分、敏感度为97.1%、特异度为77.9%时,正常组与异常组界值为3分。当AUC为0.817,评分≥5.5分,敏感度为82.1%,特异度为66.5%时,粘连型和植入型的界值为6分。当曲线下面积为0.634、评分≥6.5分、敏感度为76.4%、特异度为60.7%时,植入型和穿透型的界值为7分。结论MRI间接征象评分量表可评估产前胎盘植入程度,对临床诊疗胎盘植入有一定的指导意义。
Purpose To explore the diagnostic value of MRI indirect sign score in predicting the type of placenta implantation. Materials and Methods Clinical and MRI data of 141 patients with high suspicion of placenta implantation were retrospectively analyzed. According to the intraoperative or pathological results, the patients were divided into control group(52 cases) and abnormal group(89 cases, including 62 cases of adhesion type, 17 cases of implantation type and 10 cases of penetration type). Clinical data with statistical differences and MRI indirect signs(placental heterogeneity, intraplacental/subplacental tortuosity and increased blood vessels, lower uterine dilation, etc.) were combined to take as observation parameters and to develop the MRI score scale. The receiver operating characteristic(ROC) curves were drawn to evaluate the MRI score boundaries of control and abnormal groups(including different types of patients with placenta implantation). Results There were statistically significant differences in the number of abortion, cesarean section and placenta previa between these two groups(χ2=28.007, 19.915 and 17.163, P<0.05). According to the scoring scale, the control group showed significantly low score compared with abnormal group(2.9±1.0 vs. 5.2±1.8;t=16.645, P<0.05), and the score of adhesion type was significantly lower than that of implantation type and penetration type(4.5±1.5, 6.5±1.2 and 7.3±1.3;F=25.676, P<0.05). The ROC analysis showed that the area under the curve(AUC) was 0.824, the score was ≥2.5 points, the sensitivity was 97.1%, the specificity was 77.9%, and the cut-off value between the control group and abnormal group was 3 points, respectively. When the AUC was 0.817, the score was ≥5.5 points, the sensitivity was 82.1%, the specificity was 66.5%, and the cut-off point for determining adhesion type and implantation type was 6 points, respectively. When the AUC was 0.634, the score was ≥6.5 points, the sensitivity was 76.4%, the specificity was 60.7%, and the cut-off point for
作者
霍英杰
李孟静
袁静
高明
王成健
李培秀
HUO Yingjie;LI Mengjing;YUAN Jing;GAO Ming;WANG Chengjian;LI Peixiu(Department of Radiology,Hebei Petrochina Central Hospital,Langfang 065000,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2021年第6期609-613,共5页
Chinese Journal of Medical Imaging
基金
廊坊市科技支撑计划项目(2018013077)。
关键词
胎盘
侵入性
磁共振成像
间接征象
评分量表
诊断
鉴别
Placenta accrete
Magnetic resonance imaging
Indirect sign
Rating scale
Diagnosis,differential
