磁共振成像在诊断胎盘植入中的价值研究  

The MRI value in the diagnosis of placental implantation abnormality

作　　者：何晓燕[1] 许相丰[2] 于红[2] 刘海东[2] 

机构地区：[1]天津中医药大学研究生院,300193 [2]天津市中心妇产科医院放射科

出　　处：《实用医学影像杂志》2016年第1期12-15,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨胎盘植入的磁共振成像(MRI)表现及其诊断价值。方法回顾性分析胎盘植入患者26例,所有孕妇均由超声发现可疑胎盘植入后行MRI检查,总结其MRI的主要征象。结果 26例胎盘植入中23例合并前置胎盘,粘连型11例,植入型13例,穿透型2例。胎盘植入的MRI直接征象是在T_2WI上胎盘-子宫肌层接触面毛糙或不规则、T_2WI上低信号子宫肌层内出现与胎盘相连的高信号影(呈"波浪状"、"锯齿状")、在T_2WI上子宫肌层信号中断并浆膜层模糊或与膀胱分界不清;间接征象包括植入区胎盘内见丰富的血管影、胎盘局限增厚伴信号不均、植入区子宫壁和胎盘局限突出、植入区子宫肌壁局限变薄、膀胱顶壁不光滑或不规则、胎盘边缘或宫颈内出血。结论胎盘植入MRI的直接和间接征象对于胎盘植入的诊断和深度的判断具有重要价值。Objective To investigate the MRI features and diagnositic value of placental implantation abnormality（PIA）. Methods The MRI features of 26 cases of PIA confirmed by surgery or pathology were retrospectively analyzed. All patients underwent MRI examination in 24 hours after ultrasonography. Results Twenty-three of the 26 cases of PIA were accompanied by placenta previa,which totally or partly covered the internal cervical os. Placenta accreta（PA）,placenta increta（PI） and placenta percreta（PP） were 11 cases,13 cases and 2 cases respectively. The direct MRI features of PIA included coarseness of interface between placenta and myometrium,hypersignal intensity in normal myometrium connecting to the adjacent placenta tissue which liked wavy and jagged and focally interrupted myometrial border with loss of fat planes between uterus and bladder on T_2WI images. The indirect features of PIA included rich placental vascularity,heterogeneous signal intensity in thickening placental tissue,local bulging of uterine and placental tissue,thinning of local uterine wall,the smoothless and irregular apex wall of balder and hemorrhage between the placenta and myometrium. Conclusion The direct and indirect MRI features helped to diagnose and assess the depth of PIA.

关 键 词：胎盘植入 前置 磁共振成像 

分 类 号：R714.462[医药卫生—妇产科学]