Takahama Junko, Kitano Satoru, Marugami Nagaaki, Uehara Tomoko, Takahashi Aki, Takewa Megumi, Itoh Takahiro, Kichikawa Kimihiko
Department of Radiology, Nara Medical University, Japan.
Abdom Imaging. 2011 Feb;36(1):110-4. doi: 10.1007/s00261-010-9604-x.
To assess the role of MRI in diagnosis and predicting clinical outcome in women with retained placental tissue.
Eleven patients with pathologically proven RPT were retrospectively studied. All underwent MRI. The following MRI parameters of RPT were studied: size, signal intensity on T1- and T2-weighted images, enhancement pattern on dynamic study, extent of attachment to the uterine myometrium, and myometrial thickness at the attachment site. Clinical reports were reviewed and MRI findings were compared with respect to outcome.
RPT diameter varied from 30 to 102 mm. On T2-weighted images, 10 cases showed high intensity, while on T1-weighted images, seven cases showed high intensity. Nine cases were hypervascular. The myometrium was thinner at the attachment side than at the opposite side. All five cases in which RPT was delivered spontaneously showed an attachment area of less than a semicircle, hence broad attachment appears to impede detachment and necessitate additional therapy. After uterine arterial embolization, two patients showed complete infarction of RPT on enhanced MRI.
MRI is useful for diagnosis and follow-up of RPT. The evaluation of extent of RPT attachment to the myometrium and vascularity on MRI can help the clinical assessment.
评估磁共振成像（MRI）在诊断胎盘组织残留女性患者及预测临床结局中的作用。
对11例经病理证实为胎盘组织残留（RPT）的患者进行回顾性研究。所有患者均接受了MRI检查。研究了RPT的以下MRI参数：大小、T1加权像和T2加权像上的信号强度、动态研究中的强化模式、与子宫肌层的附着范围以及附着部位的肌层厚度。查阅临床报告，并将MRI结果与结局进行比较。
RPT直径为30至102毫米。在T2加权像上，10例显示为高强度，而在T1加权像上，7例显示为高强度。9例为高血供。附着侧的肌层比另一侧薄。自发排出RPT的所有5例患者均显示附着面积小于半圆，因此广泛附着似乎会阻碍分离并需要额外治疗。子宫动脉栓塞后，2例患者在增强MRI上显示RPT完全梗死。
MRI对RPT的诊断和随访有用。通过MRI评估RPT与肌层的附着范围和血管情况有助于临床评估。
