前置胎盘合并胎盘植入MRI诊断评分量表对临床应用的预测价值  

The Predictive Value of MRI Diagnostic Rating Scale for Placenta Previa with Placenta Implantation in Clinical Application

作　　者：马慧[1] 林剑军[1] 戴李华 王映飞[1] 蒋清华[1] 陈晓华[1] 龙俊青[2] MA Hui;LIN Jianjun;DAI Lihua(Department of Radiology,Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital,Nanning,Guangxi Zhuang Autonomous Region 530003,P.R.China)

机构地区：[1]广西壮族自治区妇幼保健院放射科,南宁530003 [2]广西壮族自治区妇幼保健院产科,南宁530003

出　　处：《临床放射学杂志》2023年第1期96-101,共6页Journal of Clinical Radiology

基　　金：广西医疗卫生适宜技术开发与推广应用项目(编号:S2019033)。

摘　　要：目的探讨磁共振评分系统预测不同胎盘植入类型的临床应用价值。方法回顾性分析91例MRI诊断为前置胎盘合并胎盘植入患者的MRI资料,通过分析产前胎盘位置、植入子宫肌层部位及深度、胎盘厚度、胎盘突出征、胎盘基底异常血管、宫颈管长度、膀胱线,建立前置胎盘合并植入MRI诊断评分量表,通过单因素分析比较不同胎盘植入类型上述变量的差异,并利用ROC曲线计算不同类型胎盘植入评分量表的临界值。结果91例研究对象中,黏连型、植入型和穿透型胎盘植入分别有28、24和39例。3种胎盘植入类型患者的胎盘位置、植入部位、深度和厚度等的组间差异具有统计学意义。ROC曲线显示,利用MRI评分量表诊断植入型和黏连型的曲线下面积为67.9%,确定植入型和黏连型的界值为7分,敏感度为75.0%,特异度为64.3%;诊断植入型和穿透型的曲线下面积为83.5%,确定植入型和穿透型的界值为11分,敏感度为66.7%,特异度为87.5%。结论MRI诊断评分量表可预估胎盘植入的类型,提高了产前胎盘植入诊断的临床实用性。Objective To investigate the clinical application value of magnetic resonance scoring system in predicting different types of placenta implantation.Methods The MRI data of 91 patients diagnosed as placenta previa with placenta implantation were analyzed retrospectively.The MRI diagnostic rating scale of placenta previa with placenta implantation was established,and the prenatal placenta location,implantation site and depth of myometrium,placenta thickness,placenta protrusion,abnormal blood vessels in placenta base,length of cervical canal and bladder line were the main research factors.The differences of the above research factors in different types of placenta implantation were compared by univariate analysis,and ROC curve was used to calculate the critical value of rating scale for patients with different types of placenta implantation.Results Among the 91 subjects,there were 28 cases of placenta accreta,24 cases of placenta increta and 39 cases of placenta percreta.There were statistically significant differences in placenta location,implantation site,depth and thickness among the three types of placenta implantation.ROC curve showed that the AUC of placenta accreta and placenta increta diagnosed by MRI rating scale was 67.9%,the critical value was 7,and the sensitivity and specificity were 75.0%and 64.3%,respectively.The AUC of placenta increta and placenta percreta by MRI rating scale was 83.5%,the critical value was 11,and the sensitivity and specificity were 66.7%and 87.5%,respectively.Conclusions MRI diagnostic rating scale can predict the type of placenta implantation and increase the clinical practicability of prenatal placental implantation diagnosis.

关 键 词：产前磁共振成像 前置胎盘 胎盘植入 评分量表 

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]