MRI评估非植入型凶险性前置胎盘发生严重产后出血

发布时间：2018-04-22 08:10

  本文选题：胎盘 + 前置　； 参考：《中国医学影像技术》2017年01期

【摘要】：目的探讨MRI评估非植入型凶险性前置胎盘发生严重产后出血的价值。方法收集114例非植入型凶险性前置胎盘患者的临床和MRI资料,分析MRI征象与严重产后出血的关系。结果单因素分析显示剖宫产次数≥2次、子宫局限性隆突、子宫下段及宫颈富血供、胎盘T2WI条状低信号、胎盘信号不均、子宫肌层变薄均易发生严重产后出血,差异有统计学差异(P均0.05)。多变量分析示剖宫产次数≥2次(X_1)、子宫局限性隆突(X_2)、胎盘T2WI条状低信号(X_3)、胎盘信号不均(X_4)、子宫下段及宫颈富血供(X_5)发生严重产后出血的风险较大,OR值分别为8.10,10.86,3.09、2.41,7.89(P均0.05)。5个危险因素建立的Logistic模型为Logistic(P)=-4.75+2.09X_1+2.39X_2+1.13X_3+0.88X_4+2.07X_5,该模型预测是否发生严重产后出血的准确率为89.21%。结论 MRI可预测非植入型凶险性前置胎盘发生严重产后出血的可能性。剖宫产次数≥2次、子宫局限性隆突、胎盘T2WI条状低信号、胎盘信号不均匀、子宫下段及宫颈富血供对预测是否发生严重产后出血的价值较大。
[Abstract]:Objective to evaluate the value of MRI in the evaluation of severe postpartum hemorrhage of non-accreta placenta previa. Methods the clinical and MRI data of 114 cases of non-accreta dangerous placenta previa were collected and the relationship between MRI signs and severe postpartum hemorrhage was analyzed. Results univariate analysis showed that the frequency of cesarean section was more than 2 times, the local protuberance of uterus, the blood supply in the lower segment of uterus and cervix, the low signal intensity of placental T2WI strip, the uneven signal of placenta, and the thinning of myometrium of uterus were all prone to severe postpartum hemorrhage. The difference was statistically significant (P < 0.05). Multivariate analysis showed that the frequency of cesarean section 鈮，

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