临床联合MRI评分量表对前置胎盘伴胎盘植入的预测价值  

Predictive value of clinical combined MRI scoring scale in placenta previa with placenta implantation

作　　者：尧麒 王欧成 揭平平 张刘璐 肖遥 YAO Qi;WANG Oucheng;JIE Pingping;ZHANG Liulu;XIAO Yao(MR Room,the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University,Luzhou,Sichuan Province 646000,China)

机构地区：[1]西南医科大学附属中医医院MR室,四川泸州646000

出　　处：《实用放射学杂志》2025年第1期72-76,共5页Journal of Practical Radiology

摘　　要：目的探讨临床联合MRI评分量表对预测前置胎盘伴胎盘植入谱系疾病(PAS)的临床价值。方法回顾性分析96例前置胎盘孕妇的临床及MRI资料,其中非PAS组37例,PAS组59例。PAS组中,黏连型胎盘植入(PA)组14例,植入型胎盘植入(PI)组33例,穿透型胎盘植入(PP)组12例。通过分析非PAS组、PA组、PI组、PP组组间变量的临床与影像学特征差异,建立评分量表,并利用受试者工作特征(ROC)曲线计算不同组的临界值。结果纳入10项临床和15项影像学特征进行评估,剖宫产次数、胎盘厚度、胎盘下异常血管、胎盘内短T2信号带等14项指标差异有统计学差异(P<0.05)。将上述指标纳入MRI评分量表。ROC曲线显示,MRI评分量表分析诊断非PAS组与PA组曲线下面积(AUC)为0.874,显著性为0.000,临界值为5.5;PA组与PI组AUC为0.784,显著性为0.002,临界值为9.5;PI组与PP组AUC为0.986,显著性为0.000,临界值为14.5。结论临床联合MRI评分量表可以评估前置胎盘是否伴PAS,并评估PAS的深度,对临床具有重要的价值。Objective To explore the clinical value of clinical combined MRI scoring scale in predicting placenta previa with placenta accreta spectrum disorders(PAS).Methods The clinical and MRI data of 96 pregnant women with placenta previa were analyzed retrospectively,including 37 cases in the non-PAS group and 59 cases in the PAS group.In the PAS group,there were 14 cases in the placenta accreta(PA)group,33 cases in the placenta increta(PI)group and 12 cases in the placenta percreta(PP)group.The differences in clinical and imaging features of the variables between non-PAS,PA,PI,and PP groups were analyzed to establish a scoring scale,and the receiver operating characteristic(ROC)curves were used to calculate the critical values of the different groups.Results Ten clinical and 15 imaging features were included for evaluation,there were statistically significant differences in 14 indicators,including the number of caesarean sections,placental thickness,abnormal subplacental vessels,and short T2 signal bands within the placenta(P<0.05).Incorporate the above indicators into the MRI scoring scale.The ROC curves showed that the area under the curve(AUC)of the MRI scoring scale analyzed diagnostic non-PAS group versus PA group was 0.874,with a significance of 0.000 and a critical value of 5.5,the AUC of the PA group versus PI group was 0.784,with a significance of 0.002 and a critical value of 9.5,and the AUC of the PI group versus PP group was 0.986,with a significance of 0.000 and a critical value of 14.5.Conclusion Clinical combined MRI scoring scale can evaluate whether placenta previa is accompanied by PAS and evaluate the depth of PAS,which has important clinical value.

关 键 词：胎盘植入谱系疾病 前置胎盘 磁共振成像 评分量表 

分 类 号：R714.462[医药卫生—妇产科学] R714.56[医药卫生—临床医学] R445.2