胎盘植入的MRI诊断  

MR imaging feature of placenta accreta and diagnostic value of MRI

作　　者：王敏红[1] 周运锋[1] 周理想[1] 翟建[1] 汪婷[1] 张钦[1] 

机构地区：[1]皖南医学院第一附属医院医学影像中心,安徽241001

出　　处：《放射学实践》2014年第9期1075-1078,共4页Radiologic Practice

基　　金：皖南医学院中青年科研基金项目(WK2012F25)

摘　　要：目的:探讨MRI对胎盘植入的诊断价值。方法:回顾性分析经临床综合诊断为胎盘植入的17例孕产妇的MRI表现。结果:17例患者子宫均不同程度增大,结合带低信号影变薄或中断;胎盘不规则增厚,植入区域子宫壁明显变薄,两者分界不清,9例T2WI上低信号的子宫肌壁内可见高信号的胎盘植入灶。DWI上12例病灶呈明显高信号,且显示较T2WI清楚,3例未见明显高信号,2例运动伪影较重,不能评价。17例MRI动态增强扫描示病灶显著强化,与子宫肌层强化程度类似,边缘强化明显,呈"花环"、"花瓣"样强化,中晚期持续、明显强化,5例病灶中央坏死区未见强化。结论:MRI平扫结合DWI能明确诊断胎盘植入及判断肌层受侵情况,动态增强扫描则有利于明确血供及鉴别诊断,因此MRI对于诊断胎盘植入具有重要价值。To investigate the MRI features in abnormal placental implantation and to assess the MRI diag-nostic values.Methods：The MRI data of 17 patients with placental implantation were retrospectively analyzed.MRI charac-teristics were reviewed and the diagnostic values were evaluated.Results：Enlarged uterus in varying degrees was found in all 17 patients.The main MRI findings were partial interruption or thinning of normal low T2 weighted signal of decidua,irreg-ular and heterogeneous thickened placenta,thinned uterine wall and unclear margins at the implantation site.There were 9 cases showing mixed hyperintense placenta within the hypointense myometrium on fat saturation T2 weighted imaging.On diffusion weighted imaging,twelve cases showed high signal while 3 cases didn＆#39;t.Two cases could not be evaluated because of severe motion artifacts.On dynamic contrast-enhanced scan,the placenta accreta and myometrium were similarly signifi-cantly enhanced.The placenta was heterogeneously enhanced and the edges were enhanced significantly appearing as ＆quot;gar-land or petal-like＆quot;shape.The central necrotic area showed no enhancement in 5 cases.The enhancement continued in mid and late phases.Conclusion：Placenta accreta and myometrial invasions can be clearly determined by MRI combined with dif-fusion weighted imaging and contrast enhanced scan.MRI has high clinical values in the diagnosis of placenta accreta.

关 键 词：胎盘植入 磁共振成像 诊断 鉴别 

分 类 号：R445.2[医药卫生—影像医学与核医学] R714.462[医药卫生—诊断学]