MRI在血管前置诊断中的应用价值初探  

The Diagnostic Value of MRI in Vasa Previa

作　　者：杨朝湘[1] 冯长征[1] 王霞[1] 汪小丽[1] 欧娟婷[1] 

机构地区：[1]广东省妇幼保健院放射科,广州510010

出　　处：《临床放射学杂志》2017年第4期582-585,共4页Journal of Clinical Radiology

摘　　要：目的探讨MRI在血管前置诊断中的价值。方法对临床病理证实的7例血管前置的MRI表现进行回顾性分析,其中2例为双胎妊娠。图像分析以SSFSE T_2WI和抑脂FSE T_2WI序列轴位和矢状位为主,重点观察宫颈内口上方及其周围的异常脐血管结构及其走行,并注意胎盘位置及变异情况。结果 7例MRI检查均于胎先露与宫颈内口间见一根或数根异常走行的脐血管。7例均存在胎盘低置或前置,以及帆状胎盘、球拍状胎盘或副胎盘变异。其中,合并血管前置的胎盘变异有帆状胎盘4例,球拍状胎盘1例,副胎盘2例。双胎妊娠均为帆状胎盘血管前置。结论 MRI在血管前置的产前诊断上发挥着重要的作用,尤其是在临床怀疑而超声诊断不明,或当超声提示帆状胎盘、多胎妊娠、胎盘低置时,应常规行MRI检查以除外血管前置。Objective To evaluate the diagnostic value of MRI in vasa previa.Methods The MR images of 7 patients with vasa previa confirmed by caesarean section and pathology were evaluated retrospectively.Of the 7 cases,2 were twin pregnancies.The axial and sagittal images of SSFSE T2 WI and fat-saturated FSE T2 WI sequences were mainly observed.Evaluation focused on abnormal umbilical vessels running along fetal membrane above or around internal cervical os.The location and variation of placentae were detected as well.Results One or more umbilical vessels between fetal presentation and internal cervical os were observed in all of 7 cases,as well as low-lying placenta or placenta previa and variant placenta were noticed.These variant placentae leading to vasa previa included 4 velamentous placentae,1 battledore placenta and 2 succenturiate placentae.The vasa previa in 2 twin pregnancies resulted from velamentous insertion of umbilical cord.Conclusion MRI plays a very important role in the antenatal diagnosis of vasa previa,especially when ultrasound examination cannot make thorough diagnotic evaluation or detects velamentous placenta,multiple pregnancy and lowlying placenta.

关 键 词：血管前置 磁共振成像 产前出血 

分 类 号：R445.2[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]