超声联合MRI在凶险性前置胎盘诊断中的应用价值观察  

The Application Value of Ultrasound Combined with MRI in the Diagnosis of Pernicious Placenta Previa

作　　者：吕新华[1] 王岩青[1] 常亚歌 LV Xin-hua;WANG Yan-qing;CHANG Ya-ge(Ultrasonography Lab,Zhengzhou People's Hospital,Zhengzhou 453003,Henan Province,China)

机构地区：[1]郑州人民医院超声科,河南郑州450003

出　　处：《中国CT和MRI杂志》2022年第8期136-138,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨超声联合MRI在凶险性前置胎盘诊断中的应用价值。方法选取2017年3月至2020年2月在郑州人民医院疑似凶险性前置胎盘患者79例作为研究对象,对所有患者行多普勒超声和核磁共振成像(MRI)检查,并与手术病理学检查“金标准”做对比,分析多普勒超声检查、多普勒超声联合MRI检查对凶险性前置胎盘的诊断价值。结果手术病理学“金标准”诊断79例受试者中凶险性胎盘前置患者64例,15例未见明显异常,多普勒超声诊断胎盘前置阳性患者56例,阴性23例,经计算准确率为82.28%,特异性为80.00%,灵敏度为82.81%,阳性预测值为94.64%,阴性预测值为52.17%,一致性Kappa值为0.522;彩色多普勒超声联合MRI诊断胎盘前置阳性患者62例,阴性17例,经计算准确率为94.94%,特异性为93.33%,灵敏度为95.31%,阳性预测值为98.39%,阴性预测值为82.35%,一致性Kappa值为0.824。超声联合MRI对凶险性前置胎盘患者的胎盘植入、胎盘粘连、胎盘穿透的准确率显著高于超声诊断(P<0.05)。结论多普勒超声联合MRI检查诊断凶险性前置胎盘及胎盘植入情况诊断的符合率高于多普勒超声检查,且联合检测对凶险性前置胎盘的位置、范围进行精准定位,在判断植入肌层的深度也有独特的优势。Objective To explore the application value of ultrasound combined with Magnetic resonance imaging(MRI)in the diagnosis of pernicious placenta previa(PPP).Methods 79 patients with suspected PPP treated in the Zhengzhou people's hospital between March 2017 and February 2020 were selected as the study subjects.All patients were examined by Doppler ultrasound and magnetic resonance imaging(MRI).With pathological examination as the golden standard,the diagnostic value of Doppler ultrasound and Doppler ultrasound combined with MRI for PPP was analyzed.Results In the 79 subjects diagnosed with surgical pathology,there were 64 cases with PPP and 15 cases without obvious abnormality.Doppler ultrasound diagnosed 56 cases with placenta previa and 23 cases without.The accuracy rate,specificity,sensitivity,positive predictive value,negative predictive value and Kappa value were 82.28%,80.00%,82.81%,94.64%,52.17%and 0.522,respectively.62 patients with placenta previa and 17 without were diagnosed by Doppler ultrasound combined with MRI.The accuracy rate,specificity,sensitivity,positive predictive value,negative predictive value and Kappa value were 94.94%,93.33%,95.31%,98.39%,82.35%and 0.824,respectively.The accuracy rates of ultrasound combined with MRI in the diagnosis of placenta accrete,placenta accreta and penetrate placenta in patients with PPP were significantly higher than those of ultrasound diagnosis(P<0.05).Conclusion The coincidence rates of Doppler ultrasound combined with MRI in the diagnosis of PPP and placenta accrete are higher than those of Doppler ultrasound.Besides,combined detection can accurately locate the position and scope of PPP.

关 键 词：多普勒超声 核磁共振成像 妊娠 凶险性前置胎盘 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R271.41[医药卫生—诊断学]