超声评分系统联合MRI预测穿透性胎盘植入的临床价值  

Clinical value of ultrasound scoring system combined with MRI in predicting penetrating placental implantation

作　　者：冼少荣 关莹 卓少霞 张贵恒 李小华[1] XIAN Shao-Rong;GUAN Ying;ZHUO Shao-Xia(The First Affiliated Hospital of Hainan Medical University,Haikou 570102,Hainan,China)

机构地区：[1]海南医学院第一附属医院,海南海口570102

出　　处：《吉林医学》2024年第3期537-541,共5页Jilin Medical Journal

基　　金：海南省卫生健康行业科研立项项目[项目编号:20A200296]。

摘　　要：目的:探讨超声评分系统联合MRI鉴别诊断穿透性与非穿透性胎盘植入的临床价值,提高对穿透性胎盘植入的预测。方法:回顾性分析2019年1月~2022年1月海南医学院第一附属医院收治的76例胎盘植入患者的临床及影像资料,所有患者产前均行超声评分及MRI检查,依据产后病理学及临床诊断将其分为穿透性组(n=8)与非穿透性组(n=68),分析两组影像图像特征,并比较两组单独的超声评分、MRI征象与超声评分联合MRI检查诊断穿透性胎盘植入的灵敏性、特异性、准确率。结果:超声评分总值≥10分时,穿透性组的发生率75.00%(6/8)高于非穿透性组[2.94%(2/68)];超声评分总值3~9分时,非穿透性组的发生率[73.53%(50/68)]高于穿透性组[25.00%(2/8)]。穿透性组子宫肌层信号中断[87.50%(7/8)]高于非穿透性组[10.29%(7/68)],胎盘侵犯宫旁组织[87.50%(7/8)]高于非穿透性组[0.00%(0/68)],差异有统计学意义(P<0.05)。超声评分联合MRI诊断穿透性胎盘植入的灵敏度、特异度、准确率性均高于单独的超声、MRI检查。结论:超声评分≥9分且MRI出现子宫肌层信号中断、胎盘侵犯宫旁组织等征象可预测胎盘穿透性植入,对穿透性胎盘植入的诊断具有较高的灵敏度、特异度、准确率,为临床鉴别诊断穿透性与非穿透性胎盘植入提供较高参考价值。Objective To explore the clinical value of ultrasound scoring system combined with MRI in discriminating between penetrating and non-penetrating placental implantation,and to improve the prediction of penetrating placental implantation.Method The clinical and imaging data of 76 patients with placental implantation treated in our hospital were retrospectively analyzed.All patients underwent prenatal ultrasound scoring and MRI examinations.According to the postpartum pathological and clinical diagnosis,they were divided into penetrating group(n=8)and non-penetrating group(n=68).The imaging features of the two groups were analyzed,the sensitivity,specificity and accuracy of single ultrasound scoring,MRI findings,and combined ultrasound scoring and MRI examination indiagnosing penetrating placental implantation were compared.Results When the total ultrasound score was≥10,the incidence of the penetrating group was 75.00%(6/8),which was significantly higher than that of the non-penetrating group(2.94%,2/68);For total ultrasound scores of 3-9,the incidence rate of the non-penetrating group was 73.53%(50/68),which was significantly higher than that of the penetrating group(25.00%,2/8).The incidence of interrupted myometrial signals in the penetrating group was 87.50%(7/8),which was significantly higher than that of the non-penetrating group(10.29%,7/68);Placental invasion of para-uterine tissues was 87.50%(7/8)in the penetrating group,which was significantly higher than 0.00%(0/68)in the non-penetrating group(P<0.05).The sensitivity,specificity,and accuracy of combined ultrasound scoring and MRI in diagnosing penetrating placental implantation were higher than those of single ultrasound or MRI examination.Conclusion An ultrasound score of≥9 and MRI findings of interrupted myometrial signals and placental invasion of para-uterine tissues can predict penetrating placental implantation,and have higher sensitivity,specificity,and accuracy in the diagnosis of penetrating placental implantation,providing higher reference v

关 键 词：超声评分 磁共振成像 胎盘植入 穿透性 

分 类 号：R445[医药卫生—影像医学与核医学]