基于超声和MRI征象的诺模图模型预测侵袭性胎盘植入的价值  

Construction of a nomogram model for predicting invasive form of placental accreta spectrum disorders in pregnant women based on ultrasound and MRI signs

作　　者：徐喻 辜秋阳[1,2] 甘玲[1,2] 庄勇[1,2] 林娜[3,4] 刘新秀[1,2] XU Yu;GU Qiuyang;GAN Ling;ZHUANG Yong;LIN Na;LIU Xinxiu(Department of Ultrasound Medicine,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Department of Ultrasound Medicine,National Regional Medical Center,Binhai Campus of the First Affiliated Hospital,Fujian Medical University,Fuzhou 350212,China;Department of Radiology,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Department of Radiology,National Regional Medical Center,Binhai Campus of the First Affiliated Hospital,Fujian Medical University,Fuzhou 350212,China)

机构地区：[1]福建医科大学附属第一医院超声医学科,福州350005 [2]福建医科大学附属第一医院滨海院区国家区域医疗中心超声医学科,福州350212 [3]福建医科大学附属第一医院影像科,福州350005 [4]福建医科大学附属第一医院滨海院区国家区域医疗中心影像科,福州350212

出　　处：《同济大学学报（医学版）》2024年第5期713-720,共8页Journal of Tongji University(Medical Science)

摘　　要：目的探讨基于超声和MRI征象的诺模图模型预测侵袭性胎盘植入的价值。方法将福建医科大学附属第一医院2018年7月-2023年6月期间确诊有胎盘植入并行超声和MRI检查的80例单胎孕妇纳入研究,以手术和/或病理结果为诊断“金标准”。通过单因素和Logistic回归分析,构建诺模图,通过受试者工作特征(receiver operating characteristic,ROC)曲线和校准曲线确定诺模图的准确性和预测效能。结果将异常胎盘腔隙、子宫膀胱界面血管过度增生、胎盘内T2WI低信号带、异质性胎盘、子宫肌瘤剥除史、前置胎盘、剖宫产史等7个独立影响因素纳入构建诺模图,ROC曲线下面积为0.93(95%CI 0.880.99)。校准曲线显示,该模型预测侵袭性胎盘植入的概率与实际概率具有高度一致性。结论基于超声和MRI征象的诺模图模型产前预测侵袭性胎盘植入有一定价值。Objective To construct a nomogram model for predicting invasive form of placental accreta spectrum disorders in pregnant women based on ultrasound and MRI signs.Methods Eighty singleton pregnant women who were confirmed to have placental accreta spectrum disorders and underwent ultrasonography and MRI examination in the First Affiliated Hospital of Fujian Medical University from July 2018 to June 2023 were enrolled.Taking surgical and/or pathological results as the gold standard,the association of ultrasound and MRI signs with placental accreta spectrum disorder was analyzed by univariate and logistic regression analysis.A nomogram model based on ultrasound and MRI signs was constructed,and the predicting efficacy of the model was determined by ROC curve and calibration curve.Results Placental lacunae,uterovesical hypervascularity,T2-dark bands,placental heterogeneity,history of uterine myomectomy,placenta previa and history of cesarean section were independent influencing factors forinvasive form of placental accreta spectrum disorders.The nomogram was constructed by including the above variables,and the area under curve(AUC)of the nomogram was 0.93(95%CI=0.880.99).The calibration curve showed that the predicted probability of placental accreta spectrum disorders by the model was highly consistent with the actual probability.Conclusion The nomogram model based on ultrasound and MRI signs has a certain value in prenatal predicting the invasive form of placental accreta spectrum disorders.

关 键 词：侵袭性胎盘植入 超声 磁共振 诺模图模型 

分 类 号：R714.46[医药卫生—妇产科学]