Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, 510000, China; Department of Radiology, Foshan Women and Children Hospital, Foshan, Guangdong, 528000, China.
Department of Radiology, Foshan Women and Children Hospital, Foshan, Guangdong, 528000, China.
Placenta. 2024 Sep 26;155:52-59. doi: 10.1016/j.placenta.2024.08.006. Epub 2024 Aug 8.
Abnormal placental cord insertions (APCIs) are significant risk factors for pregnancy complications, encompassing marginal cord insertion (MCI), velamentous cord insertion (VCI), and vasa previa (VP). While ultrasound is the primary imaging modality, its accuracy can be limited by factors such as maternal obesity and fetal positioning. Complementary to ultrasound, magnetic resonance imaging (MRI) offers a more precise visualization of the fetus, placenta, and umbilical cord relationships. This study aims to investigate the diagnostic value of prenatal magnetic resonance imaging (MRI) for APCIs compared with prenatal ultrasound.
We retrospectively collected data from 613 patients who underwent prenatal placental ultrasound and MRI. Of those who were confirmed as APCIs through surgery or pathology, the prenatal MRI features were compared with prenatal ultrasound. The diagnostic efficacy of prenatal MRI and ultrasound for APCIs was assessed based on the clinicopathological findings.
Fifty-six patients were confirmed as APCIs by surgery or pathology, comprising 31 marginal cord insertions (MCIs), 18 velamentous cord insertions (VCIs), 5 vasa previa (VP) cases, and 2 VCI cases combined with VP. Ultrasound examination showed 55.36 % sensitivity (31/56) and 98.38 % specificity (486/494) in diagnosing APCIs, whereas MRI demonstrated 87.50 % sensitivity (49/56) and 98.88 % specificity (531/537).
For APCIs complicated by placental location or morphological abnormalities, MRI demonstrates superior diagnostic efficacy compared to ultrasound in late pregnancy.
异常胎盘脐带插入（APCIs）是妊娠并发症的重要危险因素，包括边缘性脐带插入（MCI）、帆状脐带插入（VCI）和血管前置（VP）。虽然超声是主要的成像方式，但由于母体肥胖和胎儿位置等因素，其准确性可能受到限制。与超声互补的是，磁共振成像（MRI）可更精确地显示胎儿、胎盘和脐带的关系。本研究旨在探讨产前磁共振成像（MRI）对 APCIs 的诊断价值，并与产前超声进行比较。
我们回顾性收集了 613 例接受产前胎盘超声和 MRI 的患者数据。对通过手术或病理证实为 APCIs 的患者，比较产前 MRI 特征与产前超声。根据临床病理发现评估产前 MRI 和超声对 APCIs 的诊断效能。
56 例患者经手术或病理证实为 APCIs，包括 31 例边缘性脐带插入（MCI）、18 例帆状脐带插入（VCI）、5 例血管前置（VP）和 2 例 VCI 合并 VP。超声检查对 APCIs 的诊断敏感性为 55.36%（31/56），特异性为 98.38%（486/494），而 MRI 的敏感性为 87.50%（49/56），特异性为 98.88%（531/537）。
对于伴有胎盘位置或形态异常的 APCIs，MRI 在妊娠晚期的诊断效能优于超声。
