Ma Hong Li, Lü Fu Rong, Xiao Zhi Bo, DU Jin Chao, Sheng Bo
Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2019 Feb 28;41(1):86-92. doi: 10.3881/j.issn.1000-503X.10486.
Objective To compare the prenatal diagnostic value and image quality of magnetic resonance imaging(MRI)with fast imaging employing steady state acquisition(FIESTA)or single shot fast spin echo(SSFSE)sequence,in order to provide references for sequence selection of prenatal diagnosis.Methods The MRI data of 121 patients with suspected placental invasion were retrospectively analyzed. The ability of FIESTA in displaying MRI signs associated with placental invasion and its image quality were assessed and compared with SSFSE. Based on the records of cesarean section and pathological finding,the sensitivity,specificity,positive predictive values,and negative predictive values of these two sequences were calculated.Results The image quality was significantly higher in FIESTA than in SSFSE(χ =29.74,P=0.000). FIESTA had significantly higher ability to display focal interruptions in the myometrial wall than SSFSE(χ =6.750,P=0.006);in addition,the ability to display abnormal vessel in the placenta(χ =8.471,P=0.020),placental heterogeneity(χ =13.885,P=0.000),hypointense intraplacental bands(χ =4.267,P=0.035)were also significantly higher in SSFSE than in FIESTA,while the efficiency for displaying uterine bulging(χ =0.250,P=0.625),uterine recess(χ =0.167,P=0.687),uterine penetration and parametrium implantation(χ =0.800,P=0.375),and protrusion of the placenta into the cervix(χ =0.081,P=0.776)were not significantly different between these two sequences. Both sequences had a specificity of 100% in displaying uterine penetration and parametrium implantation,uterine recess,and protrusion of the placenta into the cervix. Conclusions FIESTA has better ability in displaying the contour and demarcation of placenta and uterine,whereas SSFSE is more efficient in displaying the changes of intraplacental signals. FIESTA can be used to observe the relationship between the placenta and the surrounding structures and whether the surrounding tissue is implanted,and the changes of placental signals can be observed in SSFSE. The combination of these two sequences can improve the prenatal diagnosis of placenta invasion.
目的 比较采用稳态采集快速成像（FIESTA）序列或单次激发快速自旋回波（SSFSE）序列的磁共振成像（MRI）在产前诊断中的价值及图像质量，为产前诊断序列选择提供参考。方法 回顾性分析121例疑似胎盘植入患者的MRI资料，评估FIESTA序列显示胎盘植入相关MRI征象的能力及其图像质量，并与SSFSE序列进行比较。根据剖宫产记录及病理结果，计算两种序列的敏感度、特异度、阳性预测值和阴性预测值。结果 FIESTA序列的图像质量显著高于SSFSE序列（χ² =29.74，P =0.000）。FIESTA序列显示子宫肌层局部中断的能力显著高于SSFSE序列（χ² =6.750，P =0.006）；此外，SSFSE序列显示胎盘内异常血管（χ² =8.471，P =0.020）、胎盘异质性（χ² =13.885，P =0.000）、胎盘内低信号带（χ² =4.267，P =0.035）的能力也显著高于FIESTA序列，而两种序列显示子宫膨隆（χ² =0.250，P =0.625）、子宫凹陷（χ² =0.167，P =0.687）、子宫穿透及宫旁组织植入（χ² =0.800，P =0.375）、胎盘突入宫颈（χ² =0.081，P =0.776）的效能差异无统计学意义。两种序列在显示子宫穿透及宫旁组织植入、子宫凹陷、胎盘突入宫颈方面特异度均为100%。结论 FIESTA序列在显示胎盘与子宫轮廓及分界方面能力更佳，而SSFSE序列在显示胎盘内信号变化方面更有效。FIESTA序列可用于观察胎盘与周围结构的关系及周围组织是否植入，SSFSE序列可观察胎盘信号变化。两种序列联合应用可提高胎盘植入的产前诊断水平。
