MRI征象及临床因素对胎盘植入性疾病风险的预测价值  

Predicting the risk of placenta accreta by MRI signs and clinical factors

作　　者：黄华驰 林剑军[1] 马慧[1] 陈晴 李姗珊 HUANG Huachi;LIN Jianjun;MA Hui;CHEN Qing;LI Shanshan(Department of Radiology,The Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530002,China)

机构地区：[1]广西壮族自治区妇幼保健院放射科,广西南宁530002

出　　处：《医学影像学杂志》2025年第3期78-81,共4页Journal of Medical Imaging

基　　金：广西医疗卫生适宜技术开发与推广应用项目(编号:S2019033)。

摘　　要：目的 探讨临床因素及MRI征象对胎盘植入性疾病发生风险的预测价值。方法 选取胎盘植入性疾病患者48例,另选取48例非胎盘植入者进行对照分析。记录孕产妇年龄、孕周及既往剖宫产、流产次数。对各临床因素及MRI征象进行单因素分析。计算各因素(临床因素及MRI量化指标除外)的PPV和OR值。将单因素分析有统计学意义的因素纳入二元logistic回归分析。结果 胎盘植入性疾病的存在与否和剖宫产次数、前置胎盘、胎盘主要附着位置、胎盘邻近子宫肌层情况、T_2WI低信号、宫颈上方胎盘厚度、异常血管、胎盘突出征、子宫膀胱间隙消失有关(P<0.05)。胎盘主要附着于子宫下壁、胎盘与邻近子宫肌层分界不清/肌层欠连续及其他MRI异常征象(MRI量化指标除外)存在时,OR>1(P<0.05)。剖宫产次数、前置胎盘、异常血管为胎盘植入性疾病的独立危险因素(P<0.05)。结论 通过分析临床因素及MRI征象进行风险预测,有助于胎盘植入性疾病的诊断。Objective To predict the risk of placental accretion disease by analyzing the clinical factors and MRI signs.Methods A total of 48 patients with placental accretion were collected,and 48 patients with non-placental accretion were col-lected for comparative study.The age,gestational week and the number of cesarean section and abortion were recorded.The cor-responding MRI signs were analyzed by referring to the observational indicators from previous studies.The clinical factors and MRI signs were analyzed by single factor analysis.PPV and OR values were calculated for all factors(except clinical factors and quantitative MRI indicators).Factors that had statistical significance according to univariate analysis were included in binary lo-gistic regression analysis.Results The presence or absence of placental accretion disease was related to the number of cesar-ean section,placenta previa,placenta main attachment location,situation of myometrium which was in the proximity of pla-centa,T2WI low signal,placental thickness above cervix,abnormal blood vessels,placental protrusion,and disappearance of space between uterus and uterovesical(P<0.05).When the placenta mainly attachment to the inferior uterine wall,the boundary between the placenta and the adjacent uterine myometria was unclear,myometria was not continuous,and other MRI abnormal signs(except quantitative MRI indicators)were present,OR>1(P<0.05).The number of cesarean section,placenta previa and abnormal blood vessels were independent risk factors for placental accretion disease(P<0.05).Conclusion Risk prediction by analyzing clinical factors and MRI signs is helpful for the diagnosis of placental accretion.

关 键 词：磁共振成像 临床因素 胎盘植入性疾病 风险预测 

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