磁共振HASTE序列与高频彩色多普勒超声技术对凶险型前置胎盘合并胎盘植入诊断价值比较  

Comparison of the diagnostic value of 3.0 T MRI HASTE sequence and high‑frequency color Doppler ultrasound for high‑risk placenta previa combined with placenta accreta

作　　者：赵越 胡雪杨 孙琳 张蕊[3] 王智宝 Zhao Yue;Hu Xueyang;Sun Lin;Zhang Rui;Wang Zhibao(Nuclear Magnetic Room,The No.2 Hospital of Baoding,Baoding 071000,China)

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

出　　处：《海军医学杂志》2025年第1期38-42,共5页Journal of Navy Medicine

基　　金：保定市科技计划项目(2341ZF009)。

摘　　要：目的 探究3.0 T磁共振半傅里叶单次激发快速自旋回波(HASTE)序列与高频彩色多普勒超声技术对凶险型前置胎盘合并胎盘植入的诊断价值。方法 选取2019年12月至2022年12月在保定市第二医院行剖宫产手术终止妊娠的疑似高风险凶险型前置胎盘合并胎盘植入的产妇116例,所有产妇术前均接受超声与高场强磁共振检查,以剖宫产术后病理诊断为“金标准”,分析磁共振、超声诊断结果与病理诊断结果的一致性,对比分析HASTE序列图像与高频超声诊断胎盘植入的价值。结果 116例产妇中凶险型前置胎盘合并胎盘植入阳性86例,阴性30例。超声、磁共振、超声联合磁共振诊断凶险型前置胎盘合并胎盘植入的阳性预测值分别为93.51%、97.62%、98.81%,阴性预测值分别为64.10%、87.50%、90.63%,准确度分别为83.62%、94.83%、96.55%,灵敏度分别为83.72%、95.35%、96.51%,特异度分别为83.33%、93.33%、96.67%,一致性Kappa值分别为0.611、0.868、0.912。磁共振诊断凶险型前置胎盘合并胎盘植入的准确度高于超声诊断(P<0.05)。结论 3.0 T磁共振HASTE序列诊断凶险型前置胎盘合并胎盘植入的效能更佳,诊断准确度更高。Objective To compare the value of high-field strength MRI half-Fourier single shot turbo spin-echo(HASTE)sequence with high-frequency color Doppler ultrasound for the diagnosis of placenta previa combined with placenta accreta.Methods A total of 116 pregnant women with suspected high-risk placenta previa and placenta accreta who underwent cesarean section at The No.2 Hospital of Baoding from December 2019 to December 2022 were selected as research objects.All parturients took examinations of ultrasound and high-field MRI before surgery.Pathological diagnosis after cesarean section was used as the gold standard for analysis of the consistency between MRI and ultrasound results and pathological results.The value of HASTE sequence and high-frequency ultrasound in diagnosing placenta accreta was compared.Results Pathological results confirmed that 86 patients had high-risk placenta previa and placenta accreta.The positive predictive values of ultrasound,MRI,and ultrasound+MRI in diagnosis of high-risk placenta previa combined with placenta accreta were 93.51%,97.62%,and 98.81%,respectively.The negative predictive values were 64.10%,87.50%,and 90.63%,respectively.The accuracies were 83.62%,94.83%,and 96.55%,respectively.The sensitivities were 83.72%,95.35%,and 96.51%,respectively.The specificities were 83.33%,93.33%,and 96.67%,respectively.The Kappa values for consistency were 0.611,0.868,and 0.912,respectively.The accuracy of MRI in diagnosis of high-risk placenta previa combined with placenta accreta was higher than that of ultrasound(P<0.05).Conclusion 3.0 T MRI HASTE sequence has greater efficacy and higher accuracy in diagnosis of high-risk placenta previa combined with placenta accreta.

关 键 词：凶险型前置胎盘 胎盘植入 超声 磁共振快速成像 诊断 

分 类 号：R714.462[医药卫生—妇产科学] R445.2[医药卫生—临床医学]