产前超声与低场磁共振检查在胎盘植入诊断中的价值

发布时间：2018-09-13 07:12

【摘要】：目的:比较产前多普勒超声及低场磁共振检查对胎盘植入诊断的价值。方法:回顾性分析温州医科大学附属第二医院产科2006年1月—2014年1月收治的58例产后由临床和/或病理综合诊断证实为胎盘植入患者的临床资料,且所有患者产前均有多普勒超声及MRI检查了解胎盘情况,并与产后临床和/或病理综合诊断结果进行比较,分析多普勒超声与磁共振检查对产前胎盘植入诊断的敏感性和准确性。结果:58例胎盘植入患者中,多普勒超声诊断完全符合31例,符合率为53.4%(31/58),MRI诊断完全符合39例,符合率为67.2%(39/58),两种检查方法诊断符合率比较差异无统计学意义(P0.05)。两种方法结合,诊断符合48例,符合率82.8%(48/58),三者诊断符合率比较差异有统计学意义(P0.05)。胎盘位于后壁患者,多普勒超声诊断完全符合14例,符合率为43.8%(14/32),MRI诊断完全符合23例,符合率为57.1%(23/32),两种检查方法诊断符合率比较差异有统计学意义(P0.05)。当多普勒超声出现胎盘增厚、胎盘后间隙消失等多种征象时,其诊断符合率为48.3%(28/58),单一征象往往难以确定为胎盘植入。当MRI出现直接征象时,其诊断符合率为53.4%(31/58);而间接征象的诊断符合率仅为13.8%(8/58),两者比较差异有统计学意义(P0.05)。结论:MRI检查对胎盘位于子宫后壁的患者较多普勒超声更准确,可作为多普勒超声检查的重要补充。当多普勒超声出现多种征象、MRI出现直接征象时应考虑提示存在胎盘植入。
[Abstract]:Objective:To compare the value of prenatal Doppler ultrasonography and low field magnetic resonance imaging in the diagnosis of placenta implantation.Methods:A retrospective analysis was made of 58 cases of postpartum placenta implantation confirmed by clinical and/or pathological diagnosis in the Obstetrics Department of the Second Affiliated Hospital of Wenzhou Medical University from January 2006 to January 2014. The sensitivity and accuracy of Doppler ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta were analyzed. Results: Among 58 cases of placenta accreta, 31 cases were diagnosed by Doppler ultrasonography, and the coincidence rate was 53.4% (31/58). There was no significant difference in the diagnostic coincidence rate between the two methods (P 0.05). The diagnostic coincidence rate of the two methods was 82.8% (48/58). There was significant difference in the diagnostic coincidence rate between the three methods (P 0.05). The coincidence rate was 43.8% (14/32) in 14 cases and 57.1% (23/32) in 23 cases. The coincidence rate between the two methods was statistically significant (P 0.05). The coincidence rate was 48.3% (28/58) when there were multiple signs such as placental thickening and disappearance of the posterior space. When direct signs appeared on MRI, the diagnostic coincidence rate was 53.4% (31/58), while indirect signs only 13.8% (8/58), the difference was statistically significant (P 0.05). Conclusion: MRI is more accurate than Doppler ultrasound in the placenta located in the posterior wall of the uterus, and can be an important supplement to Doppler ultrasound. When there are many signs of Doppler ultrasound, the presence of placenta accreta should be considered when MRI appears direct signs.
【作者单位】：温州医科大学附属第二医院;
【分类号】：R714.56;R445.1

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