MRI 测量不同类型胎盘植入孕妇胎盘 T2 低信号带容积及最宽血窦宽度及其鉴别价值。
The Volume of T2 Low-Signal Band and the Width of the Widest Blood Vessel in Placenta Measured by MRI in Pregnant Women with Different Types of Placental Implantation and Its Differential Value.
机构信息
Department of Radiology, Shijiazhuang No. 4 Hospital, Shijiazhuang, Hebei 050000, China.
Quality Management Office, Shijiazhuang No. 4 Hospital, Shijiazhuang, Hebei 050000, China.
出版信息
Comput Math Methods Med. 2022 Apr 21;2022:7546201. doi: 10.1155/2022/7546201. eCollection 2022.
OBJECTIVE
To explore the value of magnetic resonance imaging (MRI) in measuring the volume of T2 low-signal band and the width change of the widest blood vessel in placenta in pregnant women with different types of placenta implantation (PI).
METHODS
From November 2020 to August 2021, 116 patients in our hospital who underwent placental MRI because of ultrasound or clinical suspicion of PI were selected as the research object. According to the "gold standard" (clinical or surgical pathological results), 79 cases with PI were diagnosed as PI group, and 37 cases without PI were no PI group. The clinical features, MRI signs, T2 hyposignal zone volume, and the width of the widest blood vessel in placenta were compared between the two groups and different types of PI patients. Logistic regression was used to analyze the influencing factors of PI and PI classification, and the receiver-operating characteristic (ROC) was used to analyze the value of T2 low-signal zone volume and the widest blood vessel width in the placenta for different types of PI.
RESULTS
The history of cesarean section, uneven placental signal, the proportion of T2 low-signal band shadow, the volume of T2 low-signal band, and the width of the widest blood vessel in placenta in PI group were higher than those in non-PI group ( < 0.05); the history of cesarean section, uneven placental signal, T2 hypointense band shadow, the volume of T2 hypointense band, and the increase of the width of the widest blood vessel in placenta are independent risk factors for PI ( < 0.05); with the increase of implantation depth, the proportion of T2 hypointense band shadow, the volume of T2 hypointense band, and the width of the widest blood vessel in placenta gradually increased ( < 0.05); T2 hypointense band shadow, T2 hypointense band volume, and the widest blood vessel width in placenta are all influencing factors of PI classification ( < 0.05); ROC showed that the volume of T2 low-signal band and the width of the widest blood vessel in placenta, the AUC of combined identification of adhesive PI, implanted PI, implanted PI, and penetrating PI were 0.846 and 0.899, respectively, which was higher than that of single identification ( < 0.05).
CONCLUSION
MRI measurement of T2 hyposignal zone volume and the widest blood vessel width in placenta can be used for PI diagnosis and classification differentiation and provide reliable basis for clinical prenatal preparation and treatment planning.
目的
探讨磁共振成像（MRI）测量胎盘 T2 低信号带体积和最宽血管宽度变化在不同类型胎盘植入（PI）孕妇中的价值。
方法
选取 2020 年 11 月至 2021 年 8 月在我院因超声或临床怀疑 PI 而行胎盘 MRI 的 116 例患者作为研究对象。根据“金标准”（临床或手术病理结果），将 79 例 PI 患者诊断为 PI 组，37 例无 PI 患者为非 PI 组。比较两组及不同类型 PI 患者的临床特征、MRI 征象、T2 低信号带体积及胎盘最宽血管宽度。采用 Logistic 回归分析 PI 及 PI 分类的影响因素，采用受试者工作特征（ROC）曲线分析 T2 低信号带体积和胎盘最宽血管宽度对不同类型 PI 的价值。
结果
PI 组剖宫产史、胎盘信号不均匀、T2 低信号带影比例、T2 低信号带体积及胎盘最宽血管宽度均高于非 PI 组（ < 0.05）；剖宫产史、胎盘信号不均匀、T2 低信号带影、T2 低信号带体积及胎盘最宽血管宽度增加均为 PI 的独立危险因素（ < 0.05）；随着植入深度的增加，T2 低信号带影比例、T2 低信号带体积及胎盘最宽血管宽度逐渐增加（ < 0.05）；T2 低信号带影、T2 低信号带体积及胎盘最宽血管宽度均为 PI 分类的影响因素（ < 0.05）；ROC 显示，T2 低信号带体积和胎盘最宽血管宽度、粘连性 PI、植入性 PI、穿透性 PI 的联合鉴别 AUC 分别为 0.846、0.899，均高于单项鉴别（ < 0.05）。
结论
MRI 测量胎盘 T2 低信号带体积和最宽血管宽度可用于 PI 诊断和分类鉴别，为临床产前准备和治疗方案提供可靠依据。
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