MR两种快速成像序列在孕晚期前置胎盘伴胎盘植入诊断中的价值  

The Value of Two Fast MR Imaging Sequences in the Diagnosis of Placenta Previa with Placenta Implantation in the Third Trimester

作　　者：颜国辉 李奎[1] 邹煜[1] YAN Guohui;LI Kui;ZOU Yu(Department of Radiology,Obstetvics and Gynecology Hospital Affiliated to Zhejiang University Medical College,Hangzhou 310006,P.R.China)

机构地区：[1]浙江大学医学院附属妇产科医院放射科

出　　处：《临床放射学杂志》2018年第9期1526-1530,共5页Journal of Clinical Radiology

摘　　要：目的探讨两种快速成像序列在孕晚期诊断前置胎盘伴胎盘植入的应用价值。方法回顾性分析经手术及病理证实的47例前置胎盘伴胎盘植入患者的MRI资料,扫描均采用单次激发快速自旋回波序列（SSFSE）和稳态采集快速成像序列（FIESTA）,以手术病理结果为确诊标准,观察前置胎盘伴植入在两种快速成像序列的征象,并统计分析两者阳性检出率。结果 SSFSE和FIESTA序列对胎盘下缘覆盖宫颈内口、胎盘下缘覆盖部分宫颈内口、胎盘下缘紧贴宫颈内口边缘三种前置胎盘征象的显示,与手术病理诊断一致。两序列对胎盘植入的四种征象：胎盘信号不均匀、子宫肌层连续性的中断、胎盘突入子宫肌层、胎盘与子宫肌层之间低信号带消失显示差异有统计学意义（P〈0.05）;对胎盘内异常混乱的血管影、子宫局限性的膨隆、胎盘侵入周围器官的显示差异无统计学意义（P〉0.05）。结论 SSFSE及FIESTA序列对前置胎盘的诊断及分型无差异。SSFSE序列显示胎盘对比度较好,对胎盘植入间接征象显示有优势。FIESTA序列空间分辨率较高,对胎盘与子宫肌层分界显示清楚,对胎盘植入直接征象显示有优势。结合SSFSE及FIESTA序列表现能够提高MRI对前置胎盘伴胎盘植入的确诊率。Objective To explore the value of Two Fast Imaging Sequences in the Diagnosis of Placenta Previa with Placenta Implantation in the Third Trimester. Methods The MRI images of 47 cases with pathology confirmed Placenta Previa with Placenta Implantation were retrospectively analyzed. Single shot fast spin echo（ SSFSE） and fast imaging employing steady state acquisition sequence（ FIESTA） sequences were performed. To observe the signs of placenta previa with placenta implantation in SSFSE and FIESTA sequences. The positive detection rate of SSFSE and FIESTA was analyzed statistically. Results The signs SSFSE and FIESTA sequences showing： lower placenta cover internal os of cervix completely,lower placenta cover partial internal os of cervix and lower placenta is glued to the edge of internal os of cervix consistent with pathologic analysis. The differences of the signs： heterogeneous placenta,focal disruption of myometrium,placenta invades myometrium,loss of dark zone between placenta and myometrium showed by the two sequences have statistical significance（ P 0. 05）. However the differences of the signs： disorganized abnormal placental vascularity,abnormal uterine bulging and placenta invades surrounding organs have no statistical significance（ P 0. 05）. Conclusion There is no difference between SSFSE and FIESTA sequences in the diagnosis and classification of placenta previa. Placenta contrast and indirect signs of placenta implantation showed by SSFSE is better than FIESTA. The spatial resolution of the sequence FIESTA is higher than SSFSE. The boundary between the placenta and myometrium showed better by FIESTA. Direct signs of placenta implantation shown by FIESTA are better than SSFSE. The combination of the two sequences can improve the rate of diagnosis of placenta previa with placenta implantation.

关 键 词：前置胎盘 胎盘植入 磁共振成像 稳态采集快速成像序列 单次激发快速自旋回波序列 

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