超声与MRI检查在妊娠中晚期胎儿或胎盘异常诊断中的应用  

Comparison of ultrasound and MRI in the diagnosis of abnormality for fetus or placenta in the second and third trimesters of pregnancy.

作　　者：张颖[1] 胡永铭[2] 张武 谢兴润 陈红 黄琼曼 陈晶[1] ZHANG Ying;HU Yong-ming;ZHANG Wu;XIE Xing-run;CHEN Hong;HUANG Qiong-man;CHEN Jing(Department of Radiology,Haikou Hospital Affiliated to Xiangya School of Medicine,Central South University,Haikou 570208,Hainan,CHINA;Department of Ultrasound,Haikou Maternal and Child Health Hospital,Haikou 570102,Hainan,CHINA;Department of Radiology,the Second Xiangya Hospital of Central South University,Changsha 410011,Hunan,CHINA)

机构地区：[1]中南大学湘雅医学院附属海口医院放射科,海南海口570208 [2]海口市妇幼保健院超声科,海南海口570102 [3]中南大学湘雅二医院放射科,湖南长沙410011

出　　处：《海南医学》2020年第12期1569-1573,共5页Hainan Medical Journal

基　　金：海南省重点科技项目(编号:ZDYF2018176)。

摘　　要：目的探讨超声与磁共振成像(MRI)在妊娠中晚期胎儿或胎盘异常诊断中的应用价值。方法回顾性分析2017年1月至2019年6月在海口市人民医院和海口市妇幼保健院经超声检查怀疑存在胎儿或胎盘异常的140例中晚期孕妇的盆腹部超声及MRI影像资料,以病理结果(流产胎儿)或出生后随访结果(正常妊娠孕妇)作为参照标准,比较超声和MRI在胎儿或胎盘异常中的诊断价值。结果 140例超声检查怀疑胎儿或胎盘异常的中晚期孕妇中,病理或出生随访发现有30例无明显异常改变,差异有统计学意义(P<0.05);140例中晚期孕妇经超声筛查有41例存在胎盘植入,而病理或出生随访证实仅19例孕妇存在胎盘植入,差异有统计学意义(P<0.05);在脑发育不良、脑室发育异常等异常诊断方面,超声检查与病理或出生随访结果比较,差异均无统计学意义(P>0.05);140例超声检查怀疑胎儿或胎盘异常的孕妇的MRI检查资料与病理或出生随访发现胎儿或胎盘异常的结果基本一致,差异均无统计学意义(P>0.05)。结论 MRI检查能够更清晰地显示妊娠中晚期胎儿或胎盘异常,MRI检查可以降低超声在妊娠中晚期胎儿或胎盘异常诊断中的假阳性率。Objective To explore the value of ultrasound(US)and magnetic resonance imaging(MRI)in the diagnosis of fetal or placental abnormalities in the second and third trimesters of pregnancy.Methods The clinical data of pelvic abdomen ultrasound and MRI images of 140 women during the second and third trimesters of pregnancy suspected of fetal or placental abnormalities by ultrasound examination in Haikou People's Hospital and Haikou Maternal and Child Health Hospital from January 2017 to June 2019(Abortion fetus)was retrospectively analyzed.Taking post-natal follow-up results(normal pregnant women)as a reference standard,the diagnostic value of ultrasound and MRI in fetal or placental abnormalities was compared.Results Among 140 women during the second and third trimesters of pregnancy suspected of abnormal fetal or placental ultrasonography,there were 30 cases without obvious abnormal changes found by pathology or birth follow-up,and the difference was statistically significant(P<0.05);41 of the 140 women during the second and third trimesters of pregnancy had placenta implants,and pathology or birth follow-up confirmed that only 19 pregnant women had placenta implants(P<0.05).There was no statistically significant difference in abnormal diagnosis of brain dysplasia and ventricular development among ultrasound examination,pathology and birth follow-up results(P>0.05).The MR examination data of 140 pregnant women suspected of fetal or placental abnormalities by ultrasound examination were basically consistent with the pathological or birth follow-up findings of fetal or placental abnormalities,and the differences were not statistically significant(P>0.05).Conclusion MRI examination can more clearly show fetal or placental abnormalities in the second and third trimesters of pregnancy.MRI examination can reduce the false positive rate of US in the diagnosis of fetal or placental abnormalities in the second and third trimesters of pregnancy.

关 键 词：超声筛查 磁共振成像 胎儿 先天畸形 胎盘异常 

分 类 号：R714.5[医药卫生—妇产科学]