MRI诊断产后胎盘残留  

MRI in postpartum diagnosis of retained placental tissue

作　　者：廖伟[1] 鲁钊[1] 陈丽英[1] 张军[1] 刘兆玉[1] 

机构地区：[1]中国医科大学附属盛京医院放射科,辽宁沈阳110004

出　　处：《中国医学影像技术》2013年第5期770-773,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨产后胎盘残留的MRI表现。方法回顾性分析14例经病理证实的产后胎盘残留的MRI表现,评价和测量残留胎盘大小、T1和T2信号强度、强化特点、子宫肌层受累程度、胎盘附着处子宫肌层的厚度及对侧子宫肌层厚度、子宫大小及位置。结果手术病理证实2例正常胎盘残留,4例残留胎盘粘连,8例残留胎盘植入。术前MRI拟诊正常胎盘残留3例,胎盘残留粘连3例,胎盘残留植入8例;残留胎盘大小为35.92mm×29.05mm×33.43mm～97.24mm×68.37mm×130.67mm;T1WI高信号5例,T1WI等信号6例,T1WI等-高信号3例;T2WI高信号10例,等信号1例,混杂信号3例。2例接受MR增强扫描,胎盘组织均明显强化;胎盘附着处子宫肌层较对侧薄。结论 MRI可评价胎盘形态,清晰显示残留胎盘组织与子宫肌层关系,是评价产后胎盘残留的良好工具。Objective To assess the manifestations of MRI in postpartum diagnosis of retained placental tissue （RPT）. Methods Fourteen patients with RPT proved pathologically who underwent MR scan were retrospectively studied. The size, signal intensity on T1WI and T2WI and enhancement features of RPT, the extent of attachment to the uterus myometrium, the myometrial thickness of the attachment and opposite site, the size and position of uterus were measured and assessed. Results There were 2 cases of normal retained placenta. 4 cases of adherent placenta and 8 cases of implanted placenta diagnosed by pathology, while MRI diagnosed 3 cases of normal retained placenta, 3 cases of adherent placenta and 8 cases of implanted placenta. The diameter of RPT ranged from 35.92 mm × 29.05 mm ×33.43 mm to 97.24 mm × 68. 37 mm× 130. 67 mm on MRL On TIWI, 5 cases showed hyperintense, 6 showed isointense and 3 showed iso-hyperintense, while on T2WI, 10 cases showed hyperintense, 1 showed isointense and 3 showed mixed intense. Two cases received enhanced MR scan both showed marked enhancement. The myometrium of the attachment side was thinner than that of the opposite side. Conclusion MRI can assess the features of RPT and display the relationship between RPT and uterine myometrium, which is an ideal tool for postpartum diagnosis of RPT.

关 键 词：胎盘 滞留 侵入性胎盘 磁共振成像 

分 类 号：R714.7[医药卫生—妇产科学] R445.2[医药卫生—临床医学]