产后胎盘植入介入治疗前后MRI影像学特征及其临床价值分析  

MRI Imaging Features and Clinical Value of Postpartum Placenta Implantation Before and After Interventional Therapy

作　　者：李静[1] 聂中[2] 王灵芝[1] 张攀 代娟霞 LI Jing;NIE Zhong;WANG Ling-zhi(Department of Obstetric,Henan University of Science and Technology the First Affiliated Hospital New District Hospital,Luoyang 471000,Henan Province,China)

机构地区：[1]河南科技大学第一附属医院新区医院产科,河南洛阳471000 [2]河南科技大学第一附属医院新区医院放射科,河南洛阳471000 [3]不详

出　　处：《中国CT和MRI杂志》2018年第12期119-121,共3页Chinese Journal of CT and MRI

摘　　要：目的分析产后胎盘植入介入治疗前后的磁共振成像(MRI)影像学特征,并总结其临床价值。方法回顾性分析30例中止妊娠或产后患者临床资料,均于我院行双侧子宫动脉化疗栓塞介入治疗术,治疗前后1周行MRI检查,并与临床病理诊断结果比较,分析胎盘植入介入治疗前后MRI影像学特征。结果 MRI诊断与临床病理诊断相关性Kappa=0.721,P=0.000;介入治疗前MRI征象显示,子宫体积增大,胎盘信号强度不均匀,下肌层变薄或消失,动态增强扫描胎盘植入部分明显强化呈"结节状";介入治疗后MRI征象显示,增大子宫体积基本恢复正常,植入胎盘与宫壁融合,子宫肌层仍可观察到受侵的异常信号改变。结论 MRI检查对产后胎盘植入具有较高临床诊断价值,可清晰显示胎盘植入部位及子宫肌层受侵犯情况,可用于评价胎盘植入介入治疗的疗效。Objective To analyze the magnetic resonance imaging(MRI)features and clinical value of postpartum placenta implantation before and after interventional therapy.Methods The clinical data of 30 patients with interruption of pregnancy or delivery hospitalized in our hospital were analyzed retrospectively.All patients were given bilateral uterine artery chemoembolization interventional therapy.MRI was performed at 1 week before and after treatment,and MRI results were compared with the clinicopathological diagnosis results,and the MRI features postpartum placenta implantation before and after interventional therapy were analyzed.Results The correlation between MRI diagnosis of postpartum placenta implantation and clinical pathological diagnosis showed Kappa=0.721,P=0.000,and the difference was statistically significant.The MRI findings before interventional therapy showed that there were increased uterine volume,uneven signal intensity of placenta and the thinned or disappeared lower muscle layer,dynamic enhanced scanning showed that the placenta implantation was partially enhanced with nodular appearance.MRI findings after interventional therapy showed that the increased uterus volume was recovered to normal,and the implanted placenta was fused with the uterine wall,and the anomalous signal of invasion could still be observed in the myometrium.Conclusion MRI examination has high clinical diagnostic value in postpartum placenta implantation.It can clearly show the location of placenta implantation and the invasion of uterine myometrium,and can be used to evaluate the effect of interventional therapy for placenta implantation.

关 键 词：胎盘植入 介入治疗 磁共振成像 

分 类 号：R815[医药卫生—放射医学] R714[医药卫生—临床医学]