Kay H H, Spritzer C E
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
Obstet Gynecol. 1991 Sep;78(3 Pt 1):424-9.
Fifteen patients with third-trimester bleeding, in whom transabdominal ultrasound had failed to identify a definitive source of bleeding, underwent magnetic resonance imaging (MRI). Magnetic resonance imaging correctly identified three cases of placenta previa. In four patients, intrauterine blood was identified in hematomas. One hematoma was associated with a previa, two progressed to acute abruptions, and one was associated with a clot at the marginal cord insertion. Blood was seen leading away from the placenta in a case that progressed to an acute abruption. It was also seen in the region of the cervix in two patients with placenta previa. One patient had a normal MRI but had a fresh clot at delivery, which presumably formed after the imaging. In the remaining seven patients, MRI scans were negative and the placentas were normal at delivery. Our preliminary results suggest that MRI is helpful in evaluating patients with unexplained third-trimester bleeding.
15例孕晚期出血患者经腹部超声未能明确出血源，接受了磁共振成像（MRI）检查。MRI正确诊断出3例前置胎盘。4例患者在血肿中发现宫内积血。1例血肿与前置胎盘有关，2例进展为急性胎盘早剥，1例与脐带边缘插入处的血栓有关。1例进展为急性胎盘早剥的患者，可见血液从胎盘流出。2例前置胎盘患者在宫颈区域也可见血液。1例患者MRI检查正常，但分娩时有新鲜血栓，推测血栓是在成像后形成的。其余7例患者MRI扫描结果为阴性，分娩时胎盘正常。我们的初步结果表明，MRI有助于评估原因不明的孕晚期出血患者。
