胎盘植入的MRI诊断价值

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19例,均行常规MRI扫描,7例行动态增强扫描,3例行DWI扫描,总结其MRI图像特点及诊断价值。结果：19例患者,年龄22～37岁,平均31.8岁。MRI表现：子宫不同程度增大。子宫内膜结合带完整性破坏,多渐行性变薄至消失,边界光整。病灶内见混杂信号团块影。病灶累及仅子宫内膜结合带4例,突入肌层或肌层局部明显变薄12例,基本位于肌层内3例。动态增强,病灶不均匀强化,边缘强化明显,类似＂花环或花瓣样＂强化,坏死区不强化,动态增强特点是中晚期持续明显强化。DWI部分病灶呈明显高信号。结论：MRI能明确诊断胎盘植入及判断肌层侵入情况,动态增强有利于明确血供及鉴别诊断,弥散可反应炎症存在。

The diagnostic value of MRI in Placenta accreta

Objective：To investigate the features and diagnostic value of MRI in placenta accreta.Methods：19 cases of placenta accreta confirmed by clinically were retrospectively analyzed.All cases were examined by conventional MRI scans,7 cases by dynamic contrast-enhanced scan,3 cases by DWI scans.Results：19 patients aged 22～37 years old,with an average of 31.8 years old.The features of MRI wre as fouows.All uterus increased to various degrees.The integrity of combined zone with endometrial was destructed with the smooth border.The mixed signal mass shadow was showed in the lesions.Only the combined zone with endometria was involved in 4 cases.The muscle was involved and thin obviously in 12 cases.Lesions were located within muscular layer basically in 3 cases.By dynamic contrast enhanced,lesions were heterogeneous enhancement and the edge was enhanced significantly,similar to ＂rosette or petal-like＂.The necrotic area was not enhanced.The characteristic of dynamic contrast enhanced was continued to strengthen significantly in the mid and late.Part of lesions were showed on significantly high signal on DWI.Conclusion：Placenta accrete can be clearly determined by MRI.The information of myometrial invasions can be clear-cut by MRI.The information of blood supply and antidiastole can be clear on the dynamic contrast enhanced.The inflammatory response is definited by the sequence of DWI.