超声与MRI诊断粘连型胎盘植入的临床分析  

Clinical Analysis of Ultrasound and MRI in the Diagnosis of Adhesive Placenta Accreta

作　　者：万灵侠[1] 王春燕[1] 朱曼[1] WAN Ling-xia;WANG Chun-yan;ZHU Man(Color Doppler Room,Yongcheng People's Hospital,Yongcheng 476600,Henan Province,China)

机构地区：[1]河南省永城市人民医院彩超室

出　　处：《中国CT和MRI杂志》2019年第6期108-110,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨超声与核磁共振成像(MRI)诊断粘连型胎盘植入(PIA)的临床价值。方法回顾性分析我院收治的60例PIA患者的临床资料,均行超声和MRI检查,以临床或术后病理结果为"金标准",分析粘连型PIA的超声和MRI图像特征,比较两种检查方法的诊断价值。结果60例PIA患者中,粘连型38例(63.33%),非粘连型22例,其中植入型19例(31.67%),穿透型3例(5.00%);51例行剖宫产术终止妊娠,9例经阴道分娩,有7例行人工剥离胎盘术,2例行不完全子宫切除术,4例行子宫全切术,产后出血抢救4例;MRI诊断粘连型33例,非粘连型19例,误诊3例,漏诊5例,准确率为86.67%;超声诊断粘连型27例,非粘连型16例,误诊6例,漏诊16例,准确率为63.33%;MRI诊断粘连型PIA的灵敏度、准确率、阴性预测值均明显高于超声(P<0.05)。结论超声可作为粘连型PIA常规的筛查手段,但MRI的诊断效能优于超声,对于疑似粘连型PIA患者应结合MRI进行术前诊断。Objective To explore the clinical value of ultrasound and magnetic resonance imaging (MRI) in the diagnosis of adhesive placenta accreta (PIA).Methods The clinical data of 60 PIA patients admitted to our hospital were retrospectively analyzed.All patients were given ultrasound and MRI examinations.The clinical or postoperative pathological results were evaluated as "gold standard",and the features of ultrasound and MRI images of adhesive PIA were analyzed,and the diagnostic value of the two inspection methods was compared.Results Among 60 patients with PIA,38 cases (63.33%) were adhesive, and 22 cases were non-adhesive of which 19 cases (31.67%) were implanted and 3 cases (5.00%) were penetrating.51 patients were terminated pregnancy by cesarean section,and 9 cases of vaginal delivery,7 cases of manual removal of placenta,2 cases of incomplete hysterectomy,4 cases of hysterectomy and 4 cases of postpartum hemorrhage rescue. There were 33 adhesive cases,19 non-adhesive cases,3 cases of misdiagnosis and 5 cases of missed diagnosis by MRI diagnosis,and the accuracy in diagnosing adhesive PIA were 86.67%.There were 27 adhesive cases,16 non-adhesive cases,6 cases of misdiagnosis and 16 cases of missed diagnosis,and the accuracy in the diagnosis of adhesive PIA were 63.33%.The sensitivity,accuracy and negative predictive value of MRI in the diagnosis of adhesive PIA were significantly higher than those of ultrasound (P<0.05).Conclusion Ultrasound can be used as a routine screening method for adhesive PIA,but MRI has better diagnostic efficacy than ultrasound.For patients with suspected adhesive PIA should be given preoperative diagnosis by combining with MRI.

关 键 词：超声 MRI 粘连型胎盘植入 诊断价值 

分 类 号：R714.56[医药卫生—妇产科学] R445.1[医药卫生—临床医学]