摘要
目的探讨基于临床及常规MRI征象Logistic回归模型诺莫图预测侵袭性胎盘植入的价值。方法采用回顾性队列研究,纳入我院2016年1月~2021年5月期间怀疑有胎盘植入并行MRI检查的64例孕妇,以手术和/或病理结果为“金标准”,通过单变量和Logistic回归分析,比较有无侵袭性胎盘植入患者临床特征及常规MRI征象的差异,并构建诺莫图,采用一致性指数(C-指数)和校正曲线测定诺莫图的准确度和预测效率。结果剖宫产次数(OR=3.14,95%CI:1.01~9.79,P=0.049);前置胎盘(OR=7.20,95%CI:1.61~32.12,P=0.01)、胎盘内异常血管(OR=6.41,95%CI:1.37~29.95,P=0.018)、胎盘/子宫局限膨出(OR=7.64,95%CI:1.07~54.75,P=0.043)是侵袭性胎盘植入的独立影响因素。纳入上述变量构建诺莫图,C-指数为0.88,校正曲线显示该模型对侵袭性胎盘植入的预测概率与实际概率具有较高一致性。结论基于临床危险因素及常规MRI征象Logistic回归模型诺莫图对产前预测侵袭性胎盘植入有一定价值。
Objective To investigate the value of a clinical and magnetic resonance imaging(MRI)-based nomogram for predicting invasive forms of placental accreta spectrum(PAS)disorders including placenta increta and percreta.Methods From January 2016 to May 2021,64 pregnant women underwent MRI for suspected PAS disorders.Using surgical and/or pathological results as the gold standard,the clinical characteristics and MRI features associated with PAS disorders were retrospectively analyzed between invasive and noninvasive groups using both univariate and logistic regression analysis to construct the nomogram.The accuracy and predictive efficiency of the nomogram were measured by concordance index(C-index)and calibration curve.Results The history of previous cesarean deliveries[odds ratio(OR):3.14;95%confidence interval(CI):1.01-9.79,P=0.049],placenta previa(OR=7.20,95%CI:1.61-32.12,P=0.01),abnormal placenta vascularity(OR=6.41,95%CI:1.37-29.95,P=0.018),abnormal uterine and placenta bulging(OR=7.64,95%CI:1.07-54.75,P=0.043)were independent influencing factors imputed for the nomogram.The C-index of the nomogram was 0.88.The calibration curve showed good agreement between the probability predicted by this model and the actual probability of PAS disorders.Conclusion Logistic regression model nomogram based on clinical and conventional MRI features can be used to predict PAS disorders.
作者
车锦连
蒙印迎
龙炎英
严达
陈伟华
何凤连
梁艳
谢锦兰
CHE Jin-lian;MENG Yin-ying;LONG Yan-ying;YAN Da;CHEN Wei-hua;HE Feng-lian;LIANG Yan;XIE Jin-lan(Department of Radiology,The Seventh Affiliated Hospital of Guangxi Medical University(Wuzhou Gongren Hospital),Guangxi 543001,China)
出处
《影像诊断与介入放射学》
2022年第3期175-181,共7页
Diagnostic Imaging & Interventional Radiology
基金
梧州市科学研究与技术开发计划项目(202002100)。
关键词
磁共振成像
胎盘植入
模型
诺莫图
诊断
Magnetic resonance imaging
Placenta accreta
Model
Nomogram
Diagnosis
