磁共振成像在凶险性前置胎盘诊断中的价值研究  

Study on the value of magnetic resonance imaging in the diagnosis of pernicious placenta previa

作　　者：巫恒平 仲建全[1] 冯浩[1] 唐翎[1] 郭欢[1] WU Hengping;ZHONG Jianquan;FENG Hao;TANG Ling;GUO Huan(Department of Radiology,Zigong First People′s Hospital,Zigong,Sichuan 643000,China)

机构地区：[1]四川省自贡市第一人民医院放射科,643000

出　　处：《重庆医学》2020年第16期2740-2743,共4页Chongqing medicine

摘　　要：目的分析凶险性前置胎盘磁共振(MRI)的影像学表现,并探讨MRI检查在凶险性前置胎盘诊断中的应用价值。方法回顾性分析该院经手术及病理证实凶险性前置胎盘的38例孕妇,术前均行超声及MRI检查,MRI采用正中矢状位测量子宫前壁胎盘上缘与肚脐和宫底最高点的垂直距离,对纳入孕妇MRI影像学表现与手术、病理行对照研究。结果所有凶险性前置胎盘孕妇腹壁及子宫峡部均见切口瘢痕,胎盘均覆盖切口瘢痕区,均有前置胎盘及胎盘植入。中央型前置胎盘16例,部分型前置胎盘13例,边缘型前置胎盘9例;胎盘完全遮盖切口瘢痕区30例,部分遮盖8例;植入性胎盘15例,粘连性胎盘20例,穿透性胎盘3例。手术及病理结果与MRI产前诊断符合率为100%。结论MRI对凶险性前置胎盘孕妇产前诊断和手术方式选择具有重要意义。Objective To analyze the diagnostic effectiveness of magnetic resonance imaging(MRI)in the pernicious placenta previa,and to analyze the imaging features of pernicious placenta previa.Methods A retrospective analysis of 38 pregnant women with surgically and pathologically confirmed pernicious placenta previa was performed with ultrasound and MRI before surgery.MRI used the median sagittal position to measure the upper edge of the anterior uterine wall placenta and the highest point of the navel and uterine floor vertical distance,a comparative study of MRI imaging findings,surgery and pathology of pregnant women.Results All the pregnant women with pernicious placenta previa had incision scars on the abdominal wall and isthmus of the uterus.The placenta covered the incision scar area,and both had placenta previa and placenta implantation.There were 16 cases of central placenta previa,13 cases of partial placenta previa,and 9 cases of marginal placenta previa.The placenta completely covered the incision scar area in 30 cases,and the partial coverage in 8 cases.The implanted placenta contained 15 cases,while there were 20 cases of adherent placenta and 3 cases of penetrating placenta.The coincidence rate between surgical and pathological results and MRI prenatal diagnosis was 100%.Conclusion MRI is of great significance to the prenatal diagnosis of pregnant women with dangerous placenta previa and the selection of surgical methods.

关 键 词：凶险性 前置胎盘 侵入性胎盘 产前诊断 超声检查 产前 磁共振成像 

分 类 号：R714.2[医药卫生—妇产科学]