凶险性前置胎盘孕妇MRI征象与产后出血的关系分析  

Analysis of Relationship Between MRI Signs and Postpartum Hemorrhage in Pregnant Women with Pernicious Placenta Previa

作　　者：顾林 陈俊杰 GU Lin;CHEN Junjie(Radiology Department,Maternity and Child Care Center of Xinyu,Xinyu 338000,China;不详)

机构地区：[1]新余市妇幼保健院放射科,江西新余338000

出　　处：《中国医学创新》2024年第13期105-108,共4页Medical Innovation of China

摘　　要：目的:探讨凶险性前置胎盘(PPP)孕妇磁共振成像(MRI)征象与产后出血的关系分析。方法:回顾性分析2018年1月—2023年8月新余市妇幼保健院收治的76例PPP孕妇的临床资料,根据是否发生产后出血分为产后出血组(n=42)和非产后出血组(n=34)。比较两组MRI征象及与产后出血的相关性。结果:产后出血组胎盘植入比例高于非产后出血组,剖宫产次数多于非产后出血组(P<0.05)。产后出血组MRI征象中子宫局限性膨隆、胎盘信号不均匀、胎盘内异常血管、T_(2)WI低信号带占比均高于非产后出血组,子宫下段胎盘厚度大于非产后出血组,差异均有统计学意义(P<0.05)。两组宫颈管口扩张占比及宫颈长度比较,差异均无统计学意义(P>0.05)。受试者操作特征(ROC)曲线分析显示,PPP孕妇MRI征象子宫局限性膨隆、胎盘信号不均匀、胎盘内异常血管、T_(2)WI低信号带、子宫下段胎盘厚度预测产后出血的曲线下面积分别为0.716、0.695、0.740、0.761、0.931;敏感度分别为78.6%、71.4%、83.3%、78.6%、76.2%;特异度分别为64.7%、67.6%、64.7%、73.5%、91.2%。结论:PPP孕妇MRI征象子宫局限性膨隆、胎盘信号不均匀、胎盘内异常血管、T_(2)WI低信号带、子宫下段胎盘厚度与产后出血存在一定相关性,MRI征象检测有助于提高产后出血的诊断效能。Objective:To investigate the analysis of relationship magnetic resonance imaging (MRI) signs and postpartum hemorrhage in pregnant women with pernicious placenta previa (PPP).Method:A retrospective analysis was performed on clinical data of 76 PPP pregnant women admitted to Maternity and Child Care Center of Xinyu from January 2018 to August 2023,according to whether postpartum hemorrhage occurred,they were divided into postpartum hemorrhage group (n=42) and non-postpartum hemorrhage group (n=34).The MRI signs and correlation with postpartum hemorrhage were compared between the two groups.Result:The proportion of placenta implantation in the postpartum hemorrhage group was higher than that in the non-postpartum hemorrhage group,and the number of cesarean section was more than that in the non-postpartum hemorrhage group (P<0.05).The proportion of uterine local swelling,uneven placental signal,abnormal blood vessels in the placenta,and T_(2)WI low signal band in MRI signs on the postpartum hemorrhage group were higher than those in the non-postpartum hemorrhage group,the placental thickness in the lower uterine segment were greater than those in the non-postpartum hemorrhage group,the differences were statistically significant (P<0.05).There were no significant differences in the proportion of cervical dilation and cervical length between the two groups (P>0.05).Receiver operating characteristic (ROC) curve analysis showed that the areas under the curve of uterine local swelling,uneven placental signal,abnormal blood vessels in placenta,T_(2)WI low signal band and placenta thickness in lower uterine segment in MRI signs of PPP pregnant women in predicting postpartum hemorrhage were 0.716,0.695,0.740,0.761 and 0.931,respectively;sensitivity were 78.6%,71.4%,83.3%,78.6%,76.2%,respectively;and specificity were 64.7%,67.6%,64.7%,73.5%,91.2%,respectively.Conclusion:The MRI signs of pregnant women with PPP are associated with uterine localized swelling,uneven placenta signal,abnormal blood vessels in the placenta,low sig

关 键 词：凶险性前置胎盘 产后出血 MRI征象 相关性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R714.461[医药卫生—诊断学]