摘要
目的与产前超声和病理对照,探讨产前MRI对胎盘脐带附着异常(APCIs)的诊断价值。方法回顾性收集2013年12月至2021年12月在佛山市妇幼保健院同时行产前胎盘超声及MRI的440例患者资料,其中37例经手术或病理证实为APCIs。分析患者的产前胎盘MRI表现,并与产前超声诊断对照,计算产前MRI和超声诊断APCIs的效能。结果经手术或病理证实,37例APCIs中,17例为脐带边缘附着(MCI),13例为脐带帆状附着(VCI),5例为血管前置(VP),2例为VCI合并VP。超声诊断APCIs的灵敏度、特异度分别为59.5%(22/37)、97.8%(394/403);MRI诊断APCIs的灵敏度、特异度分别为86.5%(32/37)、98.5%(397/403)。与手术或病理结果比较,在37例APCIs中,产前MRI漏诊2例MCI、2例VCI,1例VCI误诊为副胎盘。MRI发现超声漏诊APCIs 10例,包括5例MCI、2例VP、2例VCI、1例VCI合并VP;发现超声误诊APCIs类型4例,其中2例VCI超声误诊为MCI,2例MCI超声误诊为VCI。结论对于妊娠晚期合并胎盘位置或形态异常、胎盘植入的APCIs,MRI的诊断效能优于超声。
Objective To investigate the diagnostic value of prenatal MRI in the detection of abnormal placental cord insertions(APCIs)comparing with prenatal ultrasound and pathological examination.Methods A retrospective data collection was conducted on 440 patients who underwent both prenatal placental ultrasound and MRI at the Foshan Women and Children Hospital from December 2013 to December 2021.Among them,37 cases were APCIs confirmed by surgery or pathology.The prenatal placental MRI findings were analyzed and compared with prenatal ultrasound diagnosis.The diagnostic efficacy of prenatal MRI and ultrasound in diagnosing APCIs was calculated.Results Among the 37 cases of APCIs confirmed by surgery or pathology,17 cases had marginal cord insertion(MCI),13 cases had velamentous cord insertion(VCI),5 cases had vasa previa(VP),and 2 cases had VCI combined with VP.The sensitivity and specificity of ultrasound diagnosis for APCIs were 59.5%(22/37)and 97.8%(394/403),respectively.The sensitivity and specificity of MRI diagnosis for APCIs were 86.5%(32/37)and 98.5%(397/403),respectively.Among the 37 cases of APCIs,prenatal MRI missed diagnosis of 2 cases of MCI,2 cases of VCI,and misdiagnosed 1 case of VCI as an accessory placenta.MRI identified 10 cases of APCIs missed by ultrasound,including 5 cases of MCI,2 cases of VP,2 cases of VCI,and 1 case of combined VCI with VP.Additionally,ultrasound misdiagnosed 4 cases of APCIs,including 2 cases of VCI misdiagnosed as MCI and 2 cases of MCI misdiagnosed as VCI.Conclusions For APCIs complicated with abnormalities of placental location or morphology,or placental accretion spectrum disease in late pregnancy,MRI has a higher diagnostic efficacy than ultrasound.
作者
陈凤英
张颖
张大伟
田橄
王品
廖卫彬
陈婷
范大志
刘正平
Chen Fengying;Zhang Ying;Zhang Dawei;Tian Gan;Wang Pin;Liao Weibin;Chen Ting;Fan Dazhi;Liu Zhengping(Department of Radiology,Foshan Women and Children Hospital,Foshan 528000,China;Department of Ultrasound,Foshan Women and Children Hospital,Foshan 528000,China;Department of Obstetrics,Foshan Women and Children Hospital,Foshan 528000,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2023年第10期1094-1099,共6页
Chinese Journal of Radiology
基金
广东省医学科学技术研究基金(A2021225)
佛山市卫健局医学科研课题(20210387)。
关键词
胎儿
磁共振成像
超声检查
产前
脐带附着异常
Fetus
Magnetic resonance imaging
Ultrasonography,prenatal
Abnormal placental cord insertions
