高场强磁共振HASTE序列与高频彩超诊断凶险型前置胎盘及胎盘植入的对比研究  

Comparative Study of High-field Magnetic Resonance Imaging HASTE Sequence and High-frequency Color Doppler Ultrasound in the Diagnosis of Pernicious Placenta Previa and Placenta Accreta

作　　者：赵越 胡雪杨 孙琳 张蕊[3] 王智宝 王宁[4] ZHAO Yue;HU Xue-Yang;SUN Lin;ZHANG Rui;WANG Zhi-Bao;WANG Ning(Nuclear Magnetic Room,The Second Hospital of Baoding,Baoding 071000,Hebei Province,China;Color Ultrasound Room,The Second Hospital of Baoding,Baoding 071000,Hebei Province,China;Department of Obstetrics,The Second Hospital of Baoding,Baoding 071000,Hebei Province,China;Supply Room,The Second Hospital of Baoding,Baoding 071000,Hebei Province,China)

机构地区：[1]保定市第二医院核磁室 [2]保定市第二医院彩超室 [3]保定市第二医院产科 [4]保定市第二医院供应室,河北保定071000

出　　处：《中国CT和MRI杂志》2024年第9期128-130,共3页Chinese Journal of CT and MRI

基　　金：保定市科技计划项目(2341ZF009)。

摘　　要：目的对比高场强磁共振半傅里叶单次激发快速自旋回波(HASTE)序列与高频彩超诊断凶险型前置胎盘(PPP)及胎盘植入的价值。方法回顾性分析2017年—2022年保定市第二医院收治的116例行剖宫产终止妊娠并经术后病理检查诊断为PPP的患者临床资料,所有患者均接受高场强磁共振与高频彩色多普勒超声检查,以术后病理检查结果为金标准,对比两者在PPP患者胎盘植入中的诊断价值。结果术后病理检查结果显示,116例患者中胎盘植入共81例,其余35例患者非胎盘植入;高场强磁共振HASTE序列检查结果显示:116例患者中诊断为胎盘植入68例,其余48例非胎盘植入;高频彩超检查结果显示:116例患者中诊断为胎盘植入66例,其余50例非胎盘植入;两者联合诊断结果显示:116例患者中诊断为胎盘植入84例,其余32例为非胎盘植入;以术后病理检查结果为对照,高场强磁共振HASTE序列诊断PPP患者胎盘植入的灵敏度、特异度、阳性预测值、阴性预测值、kappa值分别为81.48%、94.29%、85.34%、97.06%、0.685;高频彩超诊断PPP患者胎盘植入的灵敏度、特异度、阳性预测值、阴性预测值、kappa值分别为75.31%、85.71%、78.45%、92.42%、0.544;两种方式联合诊断PPP患者胎盘植入的灵敏度、特异度、阳性预测值、阴性预测值、kappa值分别为96.30%、82.86%、92.24%、90.63%、0.811。结论在PPP患者合并胎盘植入的诊断中,高场强磁共振HASTE序列较高频彩超具备较高的诊断价值,但两者联合可显著提升诊断效能,临床可将两者联合作为诊断PPP患者合并胎盘植入的方式。Objective To compare the value of high-field magnetic resonance imaging half-Fourier acquisition singleshot turbo spin-echo(HASTE)sequence and high-frequency color Doppler ultrasound in the diagnosis of pernicious placenta previa(PPP)and placenta accreta.Methods The clinical data of 116 patients who underwent cesarean section to terminate pregnancy and were diagnosed with PPP through postoperative pathological examination at the No.2 Hospital of Baoding from 2017 to 2022 were analyzed retrospectively.All patients were examined with high-field magnetic resonance imaging and high-frequency color Doppler ultrasound.Postoperative pathological examination results were taken as the golden standard to compare the diagnostic value of the two examination methods in patients with PPP and placenta accreta.Results Postoperative pathological results showed 81 patients with placenta accreta and 35 patients without.High-field magnetic resonance imaging HASTE sequence examination found 68 patients with placenta accreta and 48 without.High-frequency ultrasound examination found 66 patients with placenta accreta and 50 without.The combined diagnosis results of the two methods showed 84 patients with placenta accreta and 32 without.Compared with postoperative pathological results,the sensitivity,specificity,positive predictive value,negative predictive value and kappa value of high-field magnetic resonance imaging HASTE sequence for diagnosing placenta accreta in patients with PPP were 81.48%,94.29%,85.34%,97.06%and 0.685.The sensitivity,specificity,positive predictive value,negative predictive value and kappa value of high-frequency color Doppler ultrasound for diagnosing placenta accreta in patients with PPP were 75.31%,85.71%,78.45%,92.42%and 0.544.The sensitivity,specificity,positive predictive value,negative predictive value and kappa value of combined diagnosis of placenta accreta in patients with PPP were 96.30%,82.86%,92.24%,90.63%and 0.811.Conclusion For single diagnosis of placenta accreta in patients with PPP,high-field

关 键 词：凶险型前置胎盘 胎盘植入 磁共振成像 半傅里叶单次激发快速自旋回波 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]