MRI对胎盘植入的诊断价值  

Clinical Value of MRI in the Diagnosis of Placenta Accreta

作　　者：朱鸿飞[1] 孙志磊 江南[1] 李平[1] 郝正梅[1] ZHU Hong-fei;SUN Zhi-lei;JIANG Nan;LI Ping;HAO Zheng-mei(Department of Radiology,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院放射科,江苏苏州215006

出　　处：《中国血液流变学杂志》2021年第4期567-569,共3页Chinese Journal of Hemorheology

摘　　要：目的探讨产前胎盘植入的MRI表现。方法回顾性分析2017年1月-2019年12月43例怀疑胎盘植入的中、晚孕期孕妇的MRI图像。图像分析由两名经验丰富的放射科医师分别完成,意见不一致时经协商取得一致。分析内容包括胎盘的形态、位置、胎盘与子宫肌层的关系等。结果43例中,经病理证实为胎盘植入32例,其中单纯胎盘粘连4例(12.5%)、胎盘粘连与植入共存2例(6.2%)、胎盘植入肌层25例(78.1%)、胎盘穿透肌层伴膀胱侵犯1例(3.1%)。胎盘植入MRI上主要表现为胎盘子宫交界面不清,肌壁变薄或中断,其中表现为子宫膨隆征6例,胎盘内信号不均24例,胎盘内血管增多19例,子宫膀胱间隙模糊、消失1例。结论MRI成像在诊断产前胎盘植入方面具有较好的临床应用价值。Objective To investigate the MRI findings of placenta accreta.Methods The MRI images of 43 women in middle and late pregnancy who were suspected of placenta accreta from January 2017 to December 2019 were analyzed retrospectively.Image analysis(including the morphology and location of placenta,and the relationship between placenta and myometrium)was performed by two experienced radiologists respectively.An agreement would be reached through consultation in case of disagreement.Results Of the 43 cases,32 cases were confirmed as placenta accreta by pathology,including 4 cases of placenta adhesion(12.5%),2 cases of placenta adhesion with implantation(6.2%),25 cases of placental muscle layer implantation(78.1%),and 1 case of placental penetration with bladder invasion(3.1%).The main MRI manifestations were unclear interface between placenta and myometrium,thinning or interruption of uterine muscle wall,local swelling of the uterine wall(n=6),heterogeneity signal of placenta(n=24),increased blood vessels in placenta(n=19),the boundary between uterine wall and bladder wall was blurred and disappeared(n=1).Conclusion MRI has good clinical value in the diagnosis of placenta accreta.

关 键 词：磁共振成像 胎盘植入 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R714.462[医药卫生—诊断学]