胎盘植入的影像学表现及介入治疗临床研究  

Imaging Findings and Clinical Research in Interventional Treatment of Placenta Increta

作　　者：贺祥[1,2] 张和平[1,2] 靳海英[1,2] 张杰[1,2] 王晓宏[1,2] 王长福[1,2] 

机构地区：[1]河南大学淮河医院影像科 [2]河南大学医学影像研究所,河南475000

出　　处：《临床放射学杂志》2012年第5期714-717,共4页Journal of Clinical Radiology

摘　　要：目的探讨胎盘植入的影像学表现及介入治疗方法和疗效。资料与方法本组11例患者,术前作CT平扫、术前术后作超声检查、查血绒毛膜促性腺激素(HCG),行双侧子宫动脉造影。治疗采用改良式Seldinger技术穿刺插管行盆腔动脉造影,明确出血血管后将5 F Cobra导管超选择插入出血侧子宫动脉,立即用明胶海绵颗粒和明胶海绵条栓塞。栓塞前经导管注入甲氨喋呤(MTX)200 mg。结果 CT发现11例患者均有盆腔软组织包块,造影示子宫动脉异常增粗、迂曲,并见粗条状血窦及包块染色;11例患者栓塞治疗后植入性胎盘均在3～28天(平均12.3天)内自行剥离、脱落,其中3例1年后自然怀孕。结论胎盘植入通过CT、超声及子宫动脉造影可明确诊断,经导管超选择性子宫动脉栓塞术是治疗胎盘植入安全性高、疗效肯定的方法。Objective To explore the imaging findings and curative effect in interventional treatment of placenta increta.Materials and MethodsCT scan was performed before surgery and ultrasound,HCG test were performed both before and after surgery,bilateral uterine artery angiography was taken by Seldinger technique,pelviarteriography was performed to confirm bleeding vessel,then a 5F Cobra catheter was inserted superselectively into uterine artery and gelfoam were injected for embolization immediately,MTX 200mg was injected before embolization.ResultsIt was found that the 11 patients had soft tissue mass in the abdomen on CT,angiography showed uterine artery abnormal enlargement and tortuosity with rough sinusoid and mass dyeing.After embolization,placenta increta of 11 patients were all self stripped within the 3-28 days（average 12.3 days）,3 patients of which had natural pregnancy after one year.ConclusionPlacenta increta can be diagnosed clearly by CT,ultrasound and uterine artery angiography.Transcatheter uterine artery embolization（UAE） is a treatment of placenta increta,which has the safety and therapeutic effect.

关 键 词：栓塞 胎盘植入 治疗性 体层摄影术 X线计算机 

分 类 号：R714.2[医药卫生—妇产科学]