腹部放射学会和欧洲泌尿生殖放射学会关于植入性胎盘谱系疾病MRI检查的联合声明及临床病例解读  

Clinical case Interpretation of Society of Abdominal Radiology and European Society of Urogenital Ra-diology Joint Consensus Statement for MR Imaging of Placenta Accreta Spectrum Disorders

作　　者：赵玉娇[1] 尤丛 沈文[1] ZHAO Yu-jiao;YOU Cong;SHEN Wen(Department of Radiology,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院放射科/天津市影像医学研究所,天津300192

出　　处：《放射学实践》2022年第8期917-927,共11页Radiologic Practice

基　　金：天津市卫生健康科技重点项目(ZD20002);天津市第一中心医院科技基金(2020CF10);天津市医学重点学科(专科)建设项目;天津市科技计划项目(21JCQNJC01640)。

摘　　要：植入性胎盘谱系疾病(placenta accreta spectrum,PAS)与孕产妇不良母体结局高度相关,如产后严重大出血、围产期子宫切除术、邻近器官受损和死亡等。2020年美国腹部放射学会(SAR)联合欧洲泌尿生殖放射学会(ESUR)发布了针对PAS疾病的共识,规范检查流程、标准化图像采集、图像解读及报告细节,旨在提高对PAS疾病的诊断准确性。此共识声明中提出诊断PAS的7种特异性MRI征象,包括T_(2)WI上胎盘内低信号带、胎盘/子宫膨出、T_(2)WI上胎盘后低信号线消失、子宫肌层变薄/中断、膀胱壁中断、胎盘局部外生团块和胎盘床异生血管,并推荐使用结构化报告。本文对共识中推荐的PAS的MRI征象进行详细解读,并结合临床典型病例进行分析,旨在总结PAS的MRI诊断思路。Placenta accreta spectrum(PAS)are highly associated with adverse maternal outcomes,such as severe postpartum hemorrhage,peripartum hysterectomy,adjacent organ damage,and even death.In 2020,an expert committee composed of Society of Abdominal Radiology(SAR)and European Society of Urogenital Radiology(ESUR)issued a joint consensus for PAS disorders,aiming to standardize the examination process,standardize image acquisition,interpret images and report details,and improve the diagnostic accuracy of PAS disorders.This consensus statement proposed seven specific MRI signs for the diagnosis of PAS,including intraplacental dark bands on T_(2)WI,placental/ute-rine bulge,loss of retroplacental hypointense line on T_(2)WI,thinning/interruption of uterine myome-trium,interruption of bladder wall,focal exophytic placental mass and abnormal vascularization of placental bed.And the use of structural reports was recommended.In this paper,PAS MRI signs recommended in the consensus were interpreted in detail,and PAS MRI diagnostic strategy were analyzed and summarized in combination with typical clinical cases.

关 键 词：植入性胎盘 磁共振成像 胎盘疾病 结构化报告 

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