磁共振DISCO技术在胎盘植入剖宫产术后并发症的应用研究  

The Application of Magnetic Resonance DISCO Technique in the Complications After Cesarean Section with Placenta Implantation

作　　者：陈辉艳 林剑军[1] 马慧[1] 黄卫保 陈晓华[1] CHEN Huiyan;LIN Jianjun;MA Hui(Department of Radiology,Guangxi Zhuang Autonomous Region Maternal and Child Health Care Hospital,Nanning,Guangxi Zhuang Autonomous Region 530000,,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530000

出　　处：《临床放射学杂志》2023年第1期137-140,共4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：目的探讨快速动态增强磁共振扫描技术在胎盘植入剖宫产术后并发症中的应用价值。方法回顾性分析因胎盘植入剖宫产术后并发症行磁共振检查产妇23例,分别采用磁共振机型3.0 T GE SIGNA Architect、1.5 T Philips Achieva。其中3.0 T增强运用快速动态增强成像扫描(DISCO),时间分辨率6 s/期,1 min 27 s内实现总18期多期动脉动态成像;扩散加权成像运用高分辨高信号高保真的扩散成像技术(MUSE DWI)。1.5 T增强为传统容积内插动态增强,时间分辨率13.9 s/期;扩散加权成像运用为传统单激发平面回波技术。两种机型T_(2)WI均快速自旋回波抑脂。结果运用1.5 T MRI扫描11例均行DWI扫描,其中平扫3例,有2例血肿周围点状信号提示动静瘘或假性动脉瘤,1例宫腔团状影、肌层及右盆壁较多血管流空影,提示胎盘残留、动静脉瘘;动态增强8例,其中3例子宫前壁可见迂曲管状血管流空信号影,增强扫描呈管状强化;5例子宫底部混杂信号,突向宫腔内,提示胎盘残留,假性动脉瘤形成,DWI均可见高信号团,周围呈低信号。运用3.0 T MRI扫描的12例均行DISCO动态增强及MUSE DWI,动脉早期即显示动静脉瘘、形成血管团突向宫腔10例,1例假性动脉瘤合并血肿,1例动静瘘并假性动脉瘤;MSUE DWI均清晰可见高信号团块内有管条状低信号。结论3.0 T磁共振DISCO扫描在胎盘植入剖宫产术后动静脉瘘、假性动脉瘤诊断方面有较高的应用价值。MSUE DWI和T_(2)WI快速自旋回波对于未行增强的产后子宫显示丰富血管起补充作用。Objective To explore the application value of rapid dynamic contrast enhanced magnetic resonance imaging in the complications after cesarean section for placenta implantation.Methods A retrospective analysis was performed on 23 pregnant women who underwent magnetic resonance examination due to complications after cesarean section due to placenta implantation.The MRI models were 3.0 T GE SIGNA Architect and 1.5 T Philips Achieva,respectively.Among them,3.0 T enhancement uses fast dynamic enhancement imaging to scan DISCO(Differential Subsampling with Cartesian Ordering),with a time resolution of 6s/phase,and achieves a total of 18 multi-phase arterial dynamic imaging in 1 minute and 27 seconds;Diffusion weighted imaging uses the diffusion imaging technology MUSE DWI(multiplexed sensitivity encoding diffusion-weighted imaging)with high resolution,high signal and high fidelity.1.5 T enhancement is traditional volume interpolation dynamic enhancement with time resolution of 13.9s/phase;Diffusion weighted imaging is a traditional single-shot plane echo technique.T_(2)WI of both models are fast spin-echo greasing.Results DWI scanning was performed in 11 cases with 1.5 T MRI scanning,including 3 cases with plain scanning,2 cases with dotted signals around hematoma indicating arteriovenous fistula or pseudoaneurysm,1 case with mass shadow of uterine cavity,muscle layer and right pelvic wall with many vascular flow voids,indicating placenta residue and arteriovenous fistula;Dynamic enhancement was seen in 8 cases,of which 3 cases showed tortuous tubular vascular flow void signal shadow in the anterior wall of the uterus,and showed tubular enhancement after enhancement;In 5 cases,the mixed signals at the bottom of the uterus protruded into the uterine cavity,indicating the residual placenta and the formation of pseudoaneurysm.DWI showed high signal mass and low signal around.12 cases scanned with 3.0 TMRI were all performed with DISCO dynamic enhancement and MUSE DWI.10 cases showed arteriovenous fistula and formed vascula

关 键 词：快速动态增强成像 胎盘植入 动静脉瘘 假性动脉瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R719.8[医药卫生—诊断学]