MRI联合超声诊断凶险型前置胎盘  

MRI combined with ultrasound in the diagnosis of dangerous placenta previa

作　　者：吴春燕[1] 钟唐力[1] 陈正国[1] 郭仲杰[1] 周莉 赵玲 杨伟[1] WU Chunyan;ZHONG Tangli;CHEN Zhengguo;GUO Zhongjie;ZHOU Li;ZHAO Ling;YANG Wei(Mianyang Central Hospital, Mianyang 621000, Sichuan, China)

机构地区：[1]绵阳市中心医院,四川绵阳621000

出　　处：《西部医学》2021年第4期611-614,共4页Medical Journal of West China

基　　金：四川省医学科研青年创新课题(Q14034)。

摘　　要：目的探讨MRI联合超声诊断凶险型前置胎盘的临床价值。方法回顾性分析2015年4月~2020年3月我院就诊的97例疑似凶险型前置胎盘孕妇资料,探讨超声、MRI、超声+MRI(并联诊断)的诊断价值,并描述孕妇的妊娠结局和手术方式。结果97例孕妇中,74例确诊为凶险型前置胎盘。超声、MRI、超声+MRI三种诊断方法的灵敏度比较,差异有统计学意义(P<0.05),其中超声+MRI联合诊断方法的灵敏度高于单独使用超声或MRI诊断。所有孕妇均采用剖宫产的分娩方式,择期剖宫产40例(41.24%),紧急剖宫产57例(58.76%)。确诊患者62例选择先行经皮双侧子宫动脉置管及造影栓塞术后行剖宫产,占86.48%。结论利用超声或者MRI进行凶险型前置胎盘的诊断均具有比较理想的灵敏度、特异度及准确度,两种方法联合使用则可提高诊断准确率,辅助医师合理安排手术路径,估算手术的风险,可改善妊娠结局。Objective To explore the clinical value of nuclear magnetic resonance(MRI)combined with ultrasound in the diagnosis of dangerous placenta previa.Methods The data of 97 patients with suspected dangerous placenta previa admitted to our hospital from April 2015 to February 2020 were retrospectively selected.The diagnostic value of three methods of ultrasound,MRI,ultrasound+MRI(parallel diagnosis)on patients were analyzed.Results Of all 97 pregnant women,74 cases were diagnosed as dangerous placenta previa.The sensitivity data of the three diagnostic methods of ultrasound,MRI,ultrasound+MRI were statistically significant(P<0.05).The combined sensitivity of ultrasound and MRI is higher than that of ultrasound or MRI alone.All pregnant women used the delivery method of cesarean section,40 cases were elective cesarean section,accounting for 41.24%,57 cases were emergency cesarean section,58.76%.62 cases of the confirmed diagnosis were treated by percutaneous double uterine artery catheterization and embolization,accounting for 86.48%.Conclusion The diagnosis of dangerous placenta previa using ultrasound or MRI has ideal sensitivity,specificity and accuracy.When the two methods are used in combination,it can further improve the diagnosis efficiency,assist the physician to rationally arrange the surgical path,estimate the risk of surgery,and improve pregnancy outcome.

关 键 词：MRI联合超声诊断 凶险型前置胎盘 剖宫产 瘢痕 

分 类 号：R445[医药卫生—影像医学与核医学] R714.15[医药卫生—诊断学]