MRI诊断前置胎盘孕妇侵入性胎盘植入  

MRI for diagnosing invasive placenta accreta spectrum in pregnant women with placenta previa

作　　者：陈凤英[1] 张颖[1] 田橄 王品 王丹 陈婷[2] 范大志[3] 刘正平[3] 张大伟[1] CHEN Fengying;ZHANG Ying;TIAN Gan;WANG Pin;WANG Dan;CHEN Ting;FAN Dazhi;LIU Zhengping;ZHANG Dawei(Department of Radiology,Foshan Women and Children·Hospital,Foshan 528000,China;Department of Ultrasound,Foshan Women and Children·Hospital,Foshan 528000,China;Department of Obstetrics,Foshan Women and Children·Hospital,Foshan 528000,China)

机构地区：[1]佛山市妇幼保健院放射科,广东佛山528000 [2]佛山市妇幼保健院超声科,广东佛山528000 [3]佛山市妇幼保健院产科,广东佛山528000

出　　处：《中国医学影像技术》2022年第11期1685-1689,共5页Chinese Journal of Medical Imaging Technology

基　　金：佛山市科学技术局项目(2020001005573);广东省医学科学技术研究基金项目(A2021225);佛山市卫生健康局医学科研课题项目(20210387)。

摘　　要：目的 观察MRI诊断前置胎盘合并侵入性胎盘植入(PAS)的价值。方法 回顾性分析389例前置胎盘孕妇,其中299例合并PAS、包括侵入性180例及非侵入性119例;选取10个PAS特异性MRI征象,观察侵入性与非侵入性PAS患者上述征象的差异,分析不同征象诊断侵入性PAS的价值。结果 10个MRI征象占比在侵入性与非侵入性PAS患者间差异均有统计学意义(P均<0.001);其中,子宫肌层变薄/中断、胎盘突出征、胎盘缺血性梗死及膀胱壁或子宫旁组织侵犯的OR值均>10,诊断侵入性PAS的敏感度分别为58.80%、68.38%、91.67%及97.87%,特异度分别为87.62%、65.61%、60.12%及60.82%。结论 MRI表现,包括子宫肌层变薄/中断、胎盘突出征、胎盘缺血性梗死、膀胱壁或子宫旁组织侵犯可用于诊断前置胎盘合并侵入性PAS。Objective To observe the value of MRI for diagnosing invasive placenta accreta spectrum(PAS) in pregnant women with placenta previa. Methods Data of 389 pregnant women with placenta previa were retrospectively analyzed, among them, 299 cases complicated with PAS, including 180 with invasive and 119 with non-invasive PAS. Ten specific MRI signs of PAS were selected and compared between invasive and non-invasive PAS, and the value of MRI signs for diagnosing invasive PAS were analyzed. Results There were significant differences of the proportions of 10 MRI signs between invasive and non-invasive PAS(all P<0.001). OR values of myometrial thinning or interruption, placental protrusion, placental ischemic infarction and bladder wall or parauterine tissue invasion were all >10, with sensitivity for diagnosing invasive PAS of 58.80%, 68.38%, 91.67% and 97.87%, and specificity of 87.62%, 65.61%, 60.12% and 60.82%, respectively. Conclusion MRI manifestations, including myometrial thinning or interruption, placental protrusion, placental ischemic infarction and bladder wall or parauterine tissue invasion could be used for diagnosing placenta previa complicated with invasive PAS.

关 键 词：前置胎盘 胎盘植入 磁共振成像 

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