胎盘植入的MRI诊断

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。

The Diagnostic Value of MRI in Placental Implantation Abnormality

Objective To investigate the features and diagnostic value of MP, I in placental implantation abnormality（PIA）. Methods 17 cases of PIA confirmed by operating pathology were retrospectively analyzed. All cases were examined by conventional MR1 scans, 4 cases by dynamic contrast enhanced scan, and to summarize the MRI features of PIA.Results All the uterus enlarge and defomlities, 15 cases of the uterine wall was uneven thickening and local protruding, and obviously thinning attaching with placenta. All the placenta signal was uneven, 12 cases had isointensity on T1WI, hyperintense and mottling hypointense on T2WI. 10 cases show anterior and posterior parietes thinning of inferior uterine,with plaque, mottling hypointense on T2WI. 4 cases of placentas has inhomogenous enhancement with edge enhanced obviously, the lesion were ill-defined and with more blood vessels. Conclusion The main MP, I features of P1A were uterine bulging and（or） a focal outward contour bulge, heterogeneous signal intensity in the placenta and localized thinning of the uterine nmscle wall or even interrupted on T2- weighted images. Increased subplacental vascularity on the contrast enhanced also could provide useful information for the diagnosis. PIA can be clearly determined by MRI. The information of myometrial invasions can be clear showed by MRI. The infonnation of blood supply and antidiastole can be clear on the contrast enhanced.