Ayati Sedigheh, Leila Leila, Pezeshkirad Masoud, Seilanian Toosi Farokh, Nekooei Sirous, Shakeri Mohammad Taghi, Golmohammadi Mansoureh Sadat
Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Radiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Int J Reprod Biomed. 2017 Apr;15(4):225-230.
Placenta adhesive disorder (PAD) is one of the most common causes of postpartum hemorrhage and peripartum hysterectomy. The main risk factors are placenta previa and prior uterine surgery such as cesarean section. Diagnosis of placenta adhesive disorders can lead to a decrease of maternal mortality and morbidities.
The purpose of this study was to compare the accuracy of color Doppler ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of PADs.
In this is cross-sectional study, Eighty-two pregnant women who were high risk for PAD underwent color Doppler ultrasound and MRI after 18 weeks of gestation. The sonographic and MRI findings were compared with the final pathologic or clinical findings. P<0.05 was considered statistically significant.
Mean maternal age was 31.42±4.2 years. The average gravidity was third pregnancy. 46% of patients had placenta previa. The history of the previous cesarean section was seen in 79 cases (96%). The diagnosis of placenta adhesive disorder was found in 17 cases (21%). Doppler sonography sensitivity was 87% and MRI sensitivity was 76% (p=0.37). Doppler sonography specificity was 63% and MRI specificity was 83% (p=0.01).
Women with high-risk factors for PAD should undergo Doppler ultrasonography at first. When results on Doppler sonography are equivocal for PAD, MRI can be performed due to its high specificity.
胎盘粘连异常（PAD）是产后出血和围产期子宫切除术最常见的原因之一。主要危险因素是前置胎盘和既往子宫手术，如剖宫产。胎盘粘连异常的诊断可降低孕产妇死亡率和发病率。
本研究的目的是比较彩色多普勒超声和磁共振成像（MRI）在诊断PAD中的准确性。
在这项横断面研究中，82例有PAD高危因素的孕妇在妊娠18周后接受了彩色多普勒超声和MRI检查。将超声和MRI检查结果与最终病理或临床结果进行比较。P<0.05被认为具有统计学意义。
孕产妇平均年龄为31.42±4.2岁。平均妊娠次数为第三次妊娠。46%的患者有前置胎盘。79例（96%）有剖宫产史。17例（21%）诊断为胎盘粘连异常。多普勒超声敏感性为87%，MRI敏感性为76%（p=0.37）。多普勒超声特异性为63%，MRI特异性为83%（p=0.01）。
有PAD高危因素的女性应首先接受多普勒超声检查。当多普勒超声检查结果对PAD不明确时，由于MRI具有高特异性，可进行MRI检查。
