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1.
目的探讨胎盘植入的MRI表现特征及诊断价值。方法回顾性分析经临床证实的胎盘植入患者24例,4例(17%)有剖宫产史。10例(42%)患者有自然流产后清宫或人工流产史。6例(25%)合并前置胎盘。这些患者产前行MRI检查,另4例因胎盘滞留产后行MRI检查:年龄25~38岁,平均33.6岁。分娩孕周36~40周,平均37.5周。结果 20例产前胎盘植入MRI表现为:(1)子宫内膜结合带局部模糊16例;(2)结合带不见,胎盘突入到肌层内,在肌层的局部位置有显著的变薄情况的有12例,其中,基本在肌层内的有8例,至浆膜层的有4例;(3)胎盘附在子宫下段的有12例,下缘达到宫颈口或者是覆盖宫颈内口,其下部的子宫较膨大;(4)病灶T1WI呈低信号的为2例,在里边可见高信号且是不规则的,T2WI多呈现为混杂的高信号。在产妇生产之后,胎盘植入的MRI表现:有4例为结合带不见,胎盘突入到肌层内,对其增强扫描显示,胎盘为显著的持续强化信号且是不均匀的,胎盘伸入到子宫肌层。结论应用MRI进行检测对产前有没有胎盘植入与产后的胎盘滞留是不是因胎盘植入造成的诊断准确率高。  相似文献   

2.
目的探讨胎盘植入的MRI影像学特征及MRI对胎盘植入的诊断价值。方法回顾性分析经手术病理证实的17例胎盘植入患者的病史资料,17例均行常规MRI扫描,4例行增强扫描,总结其MRI影像特征。结果所有病例均有子宫不规则增大、变形。15例可见子宫壁不均匀增厚并局部外突,胎盘附着处子宫肌壁明显变薄。胎盘信号不均匀,12例可见胎盘呈不规则团块状等T1长T2信号影,T2WI内可见斑点状低信号,团块与邻近子宫壁分界不清。10例可见子宫下段前、后壁肌层明显不均变薄,内可见团块状、絮状、片状稍长T2混合信号影,边界模糊毛糙。4例增强扫描可见胎盘明显不均匀强化,边缘强化明显,与子宫肌层分界模糊胎盘下供血血管增多。结论胎盘植入的MRI征象主要包括子宫变形和(或)局部隆凸,T2WI可见子宫肌壁局部改变及高信号的胎盘侵入,增强扫描可见胎盘下血管增多,MRI能明确诊断胎盘植入及判断肌层侵入情况,增强扫描有利于明确血供及鉴别诊断。  相似文献   

3.
目的探讨自然分娩后胎盘植入的MRI表现。方法回顾性分析10例经临床综合诊断证实的自然分娩后胎盘植入患者的MRI表现,年龄28-40岁,平均34.4岁。均行常规MRI及动态增强扫描。结果子宫不同程度增大,胎盘呈分叶状5例,结节状4例,椭圆形1例。以子宫肌层为参照,T2WI-FS胎盘呈混杂信号7例,高信号为主3例。T1WI胎盘呈含略高信号的混杂信号9例,增强前T1WI-FS(THRIVE序列)高信号更明显。动态增强后9例胎盘早期明显不均匀强化。植入部肌层厚度明显变薄7例,轻度变薄3例。结论常规MRI及动态增强能很好地显示产后胎盘植入,是重要的辅助诊断工具。  相似文献   

4.
董非  张辉 《基层医学论坛》2016,(23):3247-3248
目的:探讨磁共振成像(MRI)对胎盘植入的诊断价值。方法对我院2013年9月—2015年12月经手术、病理证实的15例胎盘植入患者的MRI表现和诊断进行回顾性分析。结果 T2WI上出现不均匀低信号条索影有12例,子宫肌层变薄的有6例,子宫与胎盘的交界线(T2WI为低信号)信号缺失有10例,DWI像中高信号的胎盘突入相对低信号的子宫肌壁有6例。结论 MRI在胎盘植入的诊断上具有优越性,子宫与胎盘的交界线信号缺失,T2WI图像上不均匀信号减低,子宫肌层变薄,DWI图像上高信号的胎盘植入子宫肌层是诊断胎盘植入的重要征象。  相似文献   

5.
目的分析完全性前置胎盘合并胎盘植入MRI影像学表现及诊断价值。方法选择2017年1月至2018年10月我院收治的完全性前置胎盘合并胎盘植入患者60例,均以剖宫产手术和病理确诊,所有患者术前均进行超声和MRI检查,分析其影像学表现及诊断价值。结果完全性前置胎盘合并胎盘植入超声影像学表现为胎盘漩涡接近子宫肌层部血流异常丰富,中部无明显血流信号,胎盘实质间隙血流广泛形成,胎盘增厚,血池明显增多,胎盘后方间隙消失且其子宫肌层低回声带消失或明显变薄。MRI影像学表现为子宫多呈冬瓜形,T2WI显示子宫肌壁局部发生不同程度变薄或缺失,受胎盘入侵的子宫壁边缘呈结节状或锯齿状,部分患者T2WI呈不均匀低信号,内可见丰富流空血管影。以手术病理结果为标准,完全性前置胎盘合并胎盘植入超声检出率80.00%与MRI检出率的88.33%无显著差异(P0.05)。MRI后下壁检出率显著高于超声(P0.05)。结论MRI对完全性前置胎盘合并胎盘植入检出率与超声相近,且对子宫后壁胎盘植入检出效果优于超声,可作为临床诊断完全性前置胎盘合并胎盘植入的重要方法。  相似文献   

6.
目的探讨胎盘植入的MRI表现特点,提高对该病的认识及影像诊断准确率。方法回顾性分析鄂尔多斯市中心医院经手术病理证实的8例胎盘植入的患者。所有病例均行磁共振影像检查,总结其影像学表现。结果手术或病理证实为胎盘植入者8例,其中粘连型1例,植入型5例,穿透型2例,典型表现为胎盘不均匀增厚,部分或完全覆盖子宫颈口;胎盘植入部子宫壁明显变薄,局部胎盘与子宫壁分界不清,可穿透子宫壁,侵袭邻近器官;可见T1WI高信号、T2WI低信号出血或血肿影。结论胎盘植入MRI表现有一定特征,对大部分病例可做出提示性诊断,有助于临床诊断及治疗。  相似文献   

7.
目的对磁共振(MRI)检查胎盘植入高危患者进行诊断结果及影像学表现分析,为胎盘植入的MRI诊断提供理论依据。方法本组观察对象为2015年12月-2016年12月于我院诊断的70例胎盘植入高危患者,所有患者入组后均行常规MRI检查,详细记录MRI图像分析结果,以手术或病理诊断结果为金标准,分析MRI检查胎盘植入以及粘连型胎盘、穿透型胎盘、植入型胎盘三种分型的诊断敏感度与特异性,分析部分患者MRI图像的影像学表现。结果胎盘植入MRI影像学表现主要有子宫肌层与胎盘分界不清;局部子宫壁变薄;T2WI图像显示胎盘内有黑条带信号;子宫下部膨隆不齐;子宫与胎盘交界面存在多发纡曲血管影;子宫壁与胎盘交界处出血或血肿;膀胱壁中断;MRI诊断无胎盘植入40例、粘连型胎盘植入6例、植入型胎盘植入19例、穿透型胎盘植入5例;手术或病理诊断无胎盘植入37例、粘连型胎盘植入13例、植入型胎盘植入17例、穿透型胎盘植入3例;总体胎盘植入诊断敏感度为66.67%,特异度为83.78%,Youden指数为0.50,粘连型胎盘植入诊断敏感度为46.15%,特异度为98.25%,Youden指数为0.44,植入型胎盘植入诊断敏感度为82.35%,特异度为90.57%,Youden指数为0.73,穿透型胎盘植入诊断敏感度为66.67%,特异度为95.52%,Youden指数为0.61。结论 MRI检查胎盘植入高危患者具有多种特征性影像学表现,对于植入型胎盘植入具有较高的诊断敏感度,MRI可用于高危患者胎盘植入的初步诊断。  相似文献   

8.
彭静 《当代医学》2014,(33):22-23
目的:探讨胎盘植入诊断的彩超与磁共振的临床应用价值。方法选择龙山县人民医院于2011年1月~2013年9月拟诊为胎盘植入的30例产妇为研究对象。其中,16例通过临床与病理诊断确诊为胎盘植入,14例通过临床诊断确定为胎盘粘连或者胎盘滞留(5例为胎盘粘连,9例为胎盘滞留)。根据病理结果,将30例患者分为胎盘粘连滞留组(n=16)与胎盘植入组(n=16),针对胎盘植入组患者的彩超与磁共振检查结果进行详细记录与分析。结果16例确诊胎盘植入患者中,彩超诊断正确11例,其中8例经超声造影确诊。11例彩超诊断显示:子宫肌层与胎盘边界不清,3例胎盘植入位置肌层变薄,2例病灶内血流信号显著增强。8例实施超声造影患者,造影显示病灶呈高增强,其中4例造影结果显示病灶位置造影剂灌注出现缺失。16例确诊为胎盘植入的患者中,MRI诊断出14例,表现为子宫内部结合带局部模糊变薄,子宫增大,病灶为混杂性团块影等。结论 MRI与彩超对于胎盘植入的诊断均有一定的参考价值,但是MRI对于胎盘植入范围、植入深度等信息有更加理想的诊断价值,因此,在彩超诊断困难时,可以使用MRI进行检查。  相似文献   

9.
目的 探讨低场MRI对子宫腺肌症的诊断价值.方法 回顾分析14例经手术病理证实的子宫腺肌症的低场MRI影像表现.结果 14例中,弥漫性子宫腺肌症2例,表现为子宫体积增大呈类球形,T2WI子宫结合带弥漫性增厚,厚度13.2~35.0 mm,平均16.5 mm,结合带与肌层分界不清;在T1WI上表现为等信号,在T2WI上表现为等或略低信号,混杂有散在多发点状高信号灶;其中1例患者T1WI与T2WI均可见散在点状高信号灶.局限性子宫腺肌症12例,表现为子宫体部或底部局限性增大,相应部位结合带增厚,与肌层分界不清;在T1WI上呈等信号,T2WI上呈略低信号,病灶信号可不均匀,中央部可有多发点状高信号.结论 低场MRI对子宫腺肌症诊断有重要价值,MRI表现具有特征性,能对子宫腺肌症作出明确诊断.  相似文献   

10.
子宫腺肌症的MRI诊断价值探讨   总被引:1,自引:0,他引:1  
目的探讨子宫腺肌病的MRI表现及MRI扫描的诊断价值。方法对19例经手术病理证实的子宫腺肌症患者行MRI检查并回顾性分析。结果19例中,弥漫性子宫腺肌症11例,子宫壁结合带弥漫性增厚,结合带与肌层分界不清;在T1WI上表现为等信号,在T2WI上表现为等或略低信号,混杂有散在多发点状高信号灶。局限性子宫腺肌症8例,表现为子宫体部或底部局限性增大,相应部位结合带增厚,与肌层分界不清,在T1WI上呈等信号,T2WI上呈略低信号,病灶信号可不均匀,中央部可有多发点状高信号。结论MRI能对子宫腺肌症作出明确诊断,矢状位T2WI是显示病变的最佳扫描序列。  相似文献   

11.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

12.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

13.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

14.
FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…  相似文献   

15.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

16.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

17.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

18.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

19.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

20.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

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