凶险性前置胎盘MRI危险评分系统对剖宫产术中出血量的预测价值  

Predictive Significance of Risk Scoring System with MRI for Blood Loss of Pernicious Placenta Previa

作　　者：杨焕程 陈永露[2] 唐文艳[2] 詹泳怡 余晓滢 洪晓芳 陈楷聪 宋亭[2] YANG Huan-cheng;CHEN Yong-lu;TANG Wen-yan;ZHAN Yong-yi;YU Xiao-ying;HONG Xiao-fang;CHEN Kai-cong;SONG Ting(Department of Medical Imaging,Guangzhou Medical University,Guangzhou 511436,Guangdong,China;不详)

机构地区：[1]广州医科大学第二临床学院影像学系,广东广州511436 [2]广州医科大学附属第三医院放射科,广东广州510150

出　　处：《广东医学》2022年第2期192-196,共5页Guangdong Medical Journal

基　　金：广州市卫生健康科技一般引导项目(20191 A010060)。

摘　　要：目的探讨凶险性前置胎盘MRI危险评分系统对剖宫产术中出血量的预测价值。方法回顾性分析96例凶险性前置胎盘患者的临床及MRI资料,评估MRI征象并进行相应评分用Mann-Whitney U检验对比植入型凶险性前置胎盘与非植入型凶险性前置胎盘的评分及剖宫产术中出血量差异,评估凶险性前置胎盘MRI危险评分与剖宫产术中出血量的相关性,并用ROC曲线评估MRI危险评分预测剖宫产术中大量出血的效能。结果植入型凶险性前置胎盘MRI危险评分与剖宫产术中出血量均高于非植入型凶险性前置胎盘(P<0.001);MRI危险评分与剖宫产术中出血量存在正相关(r_(s)=0.701,P<0.001);MRI危险评分预测剖宫产术中大量出血的AUC为0.840(95%CI:0.755-0.925,P<0.001)。结论MRI危险评分系统对剖宫产术中出血量有良好的预测价值。Objective To analyze the predictive significance of risk scoring system with MRI for blood loss of pernicious placenta previa in cesarean section. Methods Ninety-six cases of pernicious placenta previa were retrospectively studied. All patients′ clinical and MRI data were collected from medical records in the HIS and PACS, respectively. An MRI risk score system was established. Mann-Whitney U test was applied to evaluate the MRI risk scores and blood loss during cesarean section between pernicious placenta previa with placenta accrete and pernicious placenta previa without placenta accrete. The correlation between the risk scores and blood loss of pernicious placenta previa was assessed. Receiver operating characteristic(ROC) analysis was used to evaluate the efficiency of MRI risk score in prediction of massive blood loss during cesarean section. Results Both the risk score and blood loss during cesarean section of pernicious placenta previa with placenta accrete were significantly higher than those of pernicious placenta previa without placenta accrete(P<0.001). Positive correlation was revealed between the risk score of pernicious placenta previa and its blood loss during cesarean section(r_(s)=0.701, P<0.001). ROC analysis showed that the AUC was 0.840(95%CI:0.755-0.925, P<0.001). Conclusion The application of prenatal risk scoring system with MRI before cesarean section has a great predictive value in blood loss during cesarean section.

关 键 词：凶险性前置胎盘 剖宫产术中出血量 危险评分系统 磁共振成像 

分 类 号：R714.4[医药卫生—妇产科学] R445.2[医药卫生—临床医学]