3D-Slicer结合MRI征象评估穿透型胎盘植入的临床研究  

Clinical study of 3D-Slicer combined with MRI signs to evaluate penetrating placental implantation

作　　者：史旭 林志旭 姚苗苗 林婷婷 SHI Xu;LIN Zhixu;YAO Miaomiao;LIN Tingting(Quanzhou Customs Comprehensive Technical Service Center,Quanzhou,Fujian 362010,China;School of Clinical Medicine,Quanzhou Medical College,Quanzhou,Fujian 362010,China;Department of Radiology,Quanzhou Women’s and Children’s Hospital,Quanzhou,Fujian 362010,China)

机构地区：[1]泉州海关综合技术服务中心,福建泉州362010 [2]泉州医学高等专科学校临床医学院,福建泉州362010 [3]泉州市妇幼保健院影像科,福建泉州362010

出　　处：《重庆医学》2025年第3期635-638,645,共5页Chongqing Medical Journal

基　　金：泉州市医疗卫生领域指导性科技计划项目(2021N134S)。

摘　　要：目的探讨3D-Slicer软件定量勾画MRI胎盘床异常增生血管对评估胎盘植入侵犯程度的临床价值。方法回顾性收集2020年7月至2023年12月泉州市妇幼保健院57例需进行MRI检查的胎盘植入患者,分为穿透型胎盘植入组(n=11)与非穿透型胎盘植入组(n=46),分析两组患者MRI形态学征象的统计学差异。筛选其中37例MRI扫描显示为胎盘床异常增生血管患者,其中穿透型胎盘植入组11例与非穿透型胎盘植入组26例,通过3D-Slicer软件勾画胎盘床异生血管表面积与体积,分析两组间差异。结果胎盘床异生血管表面积、体积在穿透型胎盘植入组与非穿透型胎盘植入组之间差异有统计学意义(P<0.05)。胎盘床异生血管表面积大是穿透性胎盘植入的独立危险因素,其预测穿透型胎盘植入的曲线下面积(AUC)为0.927。当胎盘异生血管表面积为1079.25 mm^(2)时,灵敏度为81.8%,特异度为88.5%。结论3D-Slicer软件定量中胎盘床异生血管表面积对穿透型胎盘植入的诊断效能高,异生血管表面积越大,胎盘侵犯子宫程度越深入。Objective To evaluate the degree of invasion of placental implantation by quantitative delineation of MRI placental bed abnormal hyperplasia vessels by 3D-Slicer software.Methods Fifty-seven patients with placenta implantation requiring MRI in Quanzhou Maternal and Child Health Hospital from July 2020 to December 2023 were retrospectively collected and divided into the penetrating placenta implantation group(n=11)and the non-penetrating placenta implantation group(n=46),and the differences of MRI morphological signs between the two groups were analyzed.Among them,37 patients with placental bed xenogenic vessels scanned by MRI were screened and there were 11 cases in the penetrating placental implantation group and 26 cases in the non-penetrating placental implantation group.3D-Slicer software was used to delineate the surface area and volume of placental bed xenogenic vessels,the differences between the two groups were analyzed.Results There were significant differences in the surface area and volume of xenogenic blood vessels in placental bed between the two groups(P<0.05).The large surface area of xenogenic vessels in the placental bed was an independent risk factor for penetrative placental implantation,and the predicted area under the curve(AUC)of penetrative placental implantation was 0.927.When the surface area of the placental bed was 1079.25 mm^(2),the sensitivity was 81.8%and the specificity was 88.5%.Conclusion According to 3D-Slicer software,the diagnostic efficacy of placental bed allogenic blood vessel surfac e area for penetrating placental implantation is high.The larger the allogenic blood vessel surface area is,the deeper the placental invasion of uterus is.

关 键 词：MRI 3D-Slicer软件 穿透型胎盘植入 胎盘床异生血管 

分 类 号：R445.2[医药卫生—影像医学与核医学]