胎盘植入的磁共振成像诊断价值

目的探讨胎盘植入的磁共振成像诊断价值。材料与方法对前置胎盘并有胎盘植入高危因素的65例孕妇进行磁共振检查,并与手术及病理结果对照,分析胎盘植入的磁共振征象,并计算磁共振诊断胎盘植入的敏感度、特异度。结果 65例中共有30例伴有胎盘植入,磁共振直接征象有:胎盘肌层间隙消失,肌层连续性中断,胎盘附着面对应的低信号肌层内出现异常高信号。间接征象有:(1)子宫肌层结节状膨隆;(2)胎盘增厚,信号不均匀;(3)胎盘与肌层交界面异常扩张的血管影,其中以胎盘与肌层交界面异常扩张的血管影诊断率最高。MR诊断胎盘植入的灵敏度为90.9%,特异度为89.7%,阳性预测值为88.2%,阴性预测值为92.1%。结论磁共振成像对于胎盘植入具有较高的诊断价值,能指导临床在产前制订有效的治疗手段,减少并发症。

MRI in the diagnosis of placenta accreta

Objective: To analyze the features and diagnostic value of MRI in placenta implantation abnormality (PIA). Materials and Methods: Sixty-five cases placenta previa underwent MRI scans, compare with comfirmed clinically or pathologically, obtained the sensitivity, accuracy and analyze the MRI appearances. Results: Placenta accreta was found in 12 cases, placenta increta in 18 cases. The direct signs of PIA were as follows: the bottom of decidual low signal being blurred or interrupt, myometrium becoming thinner or interrupted. The indirect signs of PIA were as follows: lower uterine segment bulging, local thickening and heterogeneous signals of placenta, the intraplacenta vascularity becoming thickening and increasing. The sensitivity, specificity, positive predictive value, negative predictive value were 90.9%, 89.7%, 88.2%, 92.1%. Conclusion: MRI has a high diagnostic value for PIA, and it can guide the clinical to maka effective treatment and reduce the complications.