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超声联合磁共振成像在产前胎盘植入患者诊断及分级中的应用。

Application of Ultrasound Combined with Magnetic Resonance Imaging in the Diagnosis and Grading of Patients with Prenatal Placenta Accreta.

机构信息

Department of Obstetrics and Gynecology Women and Children's Hospital of Chongqing Medical University, China.

出版信息

Scanning. 2022 Jul 22;2022:1199210. doi: 10.1155/2022/1199210. eCollection 2022.

Abstract

In order to study the clinical application value of placenta accreta (PIA) diagnosis and grading, the authors propose a method based on ultrasound combined with magnetic resonance imaging in the diagnosis and grading of prenatal placenta accreta patients. This method is adopted in materials and methods: a retrospective analysis of hospital patients with high suspicion of placenta accreta by clinical or ultrasonography between October 2019 and October 2021, the imaging and clinical data of 312 patients who underwent placental MRI examination. The MRI imaging data of all patients were jointly analyzed, and the main observation indicators are as follows: (1) dark zone in the placenta, (2) disruption of the border of the myometrium, (3) disruption of the myometrium, (4) abnormal blood vessels in the placenta, (5) enlargement of the lower part of the uterus, and (6) local bulge of the bladder/or invasion of the adjacent tissues of the uterus. The results show the following: in MRI combined with ultrasonography ( < 0.05), there was no statistical significance in the specificity and accuracy of MRI combined with ultrasound to diagnose PIA ( > 0.05). The comparison of graded diagnostic accuracy showed that in ultrasound alone < MRI alone < MRI combined with ultrasound, the differences were statistically significant ( < 0.05). Ultrasound combined with MRI in the diagnosis of placenta accreta is in good agreement with the clinical and surgical pathological results; MRI examination can be used as an important method for prenatal placenta accreta screening. MRI can classify placenta accreta to some extent.

摘要

为了研究胎盘植入(PIA)的临床应用价值,作者提出了一种基于超声联合磁共振成像的产前胎盘植入患者诊断和分级方法。方法:回顾性分析 2019 年 10 月至 2021 年 10 月医院临床或超声高度怀疑胎盘植入的患者,对 312 例行胎盘 MRI 检查的患者的影像学和临床资料进行分析。所有患者的 MRI 成像资料均进行联合分析,主要观察指标如下:(1)胎盘暗区,(2)肌层边界中断,(3)肌层中断,(4)胎盘内异常血管,(5)子宫下段增大,(6)膀胱局部隆起/子宫邻近组织侵犯。结果:MRI 联合超声(<0.05)在诊断 PIA 的特异性和准确性方面与超声联合 MRI 无统计学意义(>0.05)。分级诊断准确性比较显示,单独超声<单独 MRI<超声联合 MRI,差异有统计学意义(<0.05)。超声联合 MRI 对胎盘植入的诊断与临床和手术病理结果具有良好的一致性;MRI 检查可作为产前胎盘植入筛查的重要方法。MRI 可在一定程度上对胎盘植入进行分类。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a241/9337953/6f0b80709460/SCANNING2022-1199210.001.jpg

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