不同影像学方式诊断中央型前置胎盘合并胎盘植入的对比研究  

A Comparative Study of Different Imaging Modalities in the Diagnosis of Central Placenta Praevia with Placental Implantation

作　　者：巢书山 邹运兰 陈志刚 陈志红 卢慧韬 CHAO Shushan;ZOU Yunlan;CHEN Zhigang;CHEN Zhihong;LU Huitao(Yichun Maternal and Child Health Hospital,Jiangxi Province,Yichun 336000,China;不详)

机构地区：[1]江西省宜春市妇幼保健院,江西宜春336000 [2]江西省宜春市第二人民医院

出　　处：《中国医学创新》2022年第36期143-147,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(SKJP220201471)。

摘　　要：目的:评估磁共振成像(MRI)、彩色多普勒超声对中央型前置胎盘(CPP)合并胎盘植入的诊断价值。方法:回顾性分析2019年1月-2022年8月宜春市妇幼保健院收治的60例CPP患者的临床资料,患者均接受彩色超声检查与MRI检查,对两种影像学方式的诊断效能进行评价。结果:MRI、彩色超声对CPP合并胎盘植入的敏感度分别为95.35%、81.40%,准确率分别为95.00%、78.33%。MRI对CPP合并胎盘植入敏感度和准确率均高于彩色超声,差异均有统计学意义(P<0.05)。CCP合并胎盘植入产妇的胎盘与子宫壁关系分界不清、有子宫肌层胎盘样回声、胎盘内有血池、有胎盘后间隙占比均高于CCP非胎盘植入产妇(P<0.05)。CCP合并胎盘植入产妇的胎盘信号不均匀/欠均匀、胎盘内迂曲流空血管影、子宫下段肿胀、子宫肌层局限性变薄/中断占比均高于CCP非胎盘植入产妇(P<0.05)。MRI对粘连型胎盘植入的检出率为93.33%,高于彩色超声的53.33%,差异有统计学意义(P<0.05)。结论:在CPP合并胎盘植入诊断中,MRI诊断的准确率更高,可弥补彩色超声在粘连型胎盘植入诊断方面的不足。Objective:To assess the diagnostic value of magnetic resonance imaging(MRI) and colour Doppler ultrasound for central placenta praevia(CPP) with placental implantation.Method:The clinical data of 60 CPP patients admitted to Yichun Maternal and Child Health Hospital from January 2019 to August 2022 were retrospectively analyzed,all patients received color ultrasound examination and MRI examination,and the diagnostic efficacy of the two imaging methods were evaluated.Result:The sensitivity of MRI and color ultrasound to CPP with placental implantation were 95.35% and 81.40%,respectively,and the accuracy rates were 95.00% and 78.33%,respectively.The sensitivity and accuracy of MRI for CPP with placental implantation were higher than those of color ultrasound,the differences were statistically significant(P<0.05).The proportion of unclear boundary between placenta and uterine wall,placental echo with myotomyme,blood pool in placenta and postplacental space in CCP maternal with placental implantation were higher than those CCP maternal with non-placental implantation(P<0.05).The proportion of uneven/uneven placental signal,tortuous empty blood vessel shadow in placenta,lower uterine swelling and localized thinning/interruption of myoma in CCP maternal with placental implantation were higher than those in CCP maternal with non-placental implantation(P<0.05).The detection rate of adherent placental implantation by MRI was 93.33%,which was higher than 53.33% by color ultrasound,the difference was statistically significant(P<0.05).Conclusion:In the diagnosis of CPP with placental implantation,MRI has higher accuracy rate and can compensate for the deficiency of colour ultrasound in the diagnosis of adherent placental implantation.

关 键 词：中央型前置胎盘 胎盘植入 彩色多普勒超声 磁共振成像 

分 类 号：R714.4[医药卫生—妇产科学]