Masselli Gabriele, Gualdi Gianfranco
Radiology Department, First Faculty of Medicine, Università di Roma Sapienza, Viale del Policlinico 155, Rome, Italy.
Abdom Imaging. 2013 Jun;38(3):573-87. doi: 10.1007/s00261-012-9929-8.
Imaging of the placenta can have a profound impact on patient management, owing to the morbidity and mortality associated with various placental conditions. Placental conditions affecting the mother and fetus include molar pregnancies, placental hematoma, abruption, previa, accreta, vasa previa, chorioangioma, and retained products of conception. Although uncommon, abnormalities of the placenta are important to recognize owing to the potential for maternal and fetal morbidity and mortality. Sonography remains the first imaging modality for evaluation of the placenta. Magnetic resonance (MR) imaging has many unique properties that make it well-suited for imaging of the placenta: the multi-planar capabilities, the improved tissue contrast that can be obtained using a variety of pulse sequences and parameters and the lack of ionizing radiation; MR imaging can be of added diagnostic value when further characterization is required. In this article, we review the appearances and the role of MRI in diagnosis and management of these conditions. We present our clinical perspective on diagnosing these challenging problems with MRI and review the imaging findings that can lead to a correct diagnosis.
由于各种胎盘疾病相关的发病率和死亡率,胎盘成像对患者管理可能产生深远影响。影响母亲和胎儿的胎盘疾病包括葡萄胎妊娠、胎盘血肿、胎盘早剥、前置胎盘、胎盘植入、前置血管、绒毛膜血管瘤和稽留流产。虽然胎盘异常并不常见,但鉴于其对母婴发病率和死亡率的潜在影响,识别这些异常很重要。超声检查仍然是评估胎盘的首选成像方式。磁共振(MR)成像具有许多独特的特性,使其非常适合胎盘成像:多平面成像能力、使用各种脉冲序列和参数可获得的更好的组织对比度以及无电离辐射;当需要进一步特征化时,MR成像可具有额外的诊断价值。在本文中,我们回顾了MRI在这些疾病诊断和管理中的表现及作用。我们从临床角度阐述了用MRI诊断这些具有挑战性问题的方法,并回顾了可导致正确诊断的影像学表现。