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磁共振成像对异常胎盘形态的研究及其与病理发现的相关性。

Magnetic resonance imaging of abnormal placental shapes with correlation with pathologic findings.

机构信息

Department of Radiology, Foshan Women and Children Hospital, Foshan, Guangdong, China.

Department of Obstetrics, Foshan Women and Children Hospital, Foshan, Guangdong, China.

出版信息

J Matern Fetal Neonatal Med. 2024 Dec;37(1):2399943. doi: 10.1080/14767058.2024.2399943. Epub 2024 Sep 4.

DOI:10.1080/14767058.2024.2399943
PMID:39231793
Abstract

OBJECTIVE

This study aimed to investigate the magnetic resonance imaging (MRI) characteristics of abnormal placental shapes (APS) compared with prenatal ultrasound.

METHODS

From an initial cohort of 613 women with a high prevalence of placenta accreta spectrum (PAS) disorders, the MRI findings of 27 pregnant women with APS who underwent antenatal ultrasound and MRI examinations before delivery were retrospectively analyzed. The clinicopathological findings were used as the gold standard, and the sensitivity, specificity, and accuracy of antenatal MRI and a multidisciplinary team experienced in diagnosing APS were assessed.

RESULTS

The 27 patients diagnosed with APS included 14 cases of succenturiate placenta, eight cases of the bilobed placenta, two cases of the circumvallate placenta, and one case each of placenta chorioangioma, placenta membranacea, and placental mesenchymal dysplasia. The sensitivity and specificity of APS classification with antenatal MRI were 40.74% (11/27) and 97.65% (498/510), respectively. Nonetheless, the multidisciplinary team achieved a higher sensitivity and specificity of up to 96.29% (26/27) and 99.22% (506/510), respectively.

CONCLUSION

We have demonstrated the complementary role of MRI and ultrasound in the detection of placental shapes in the setting of MRI images, highlighting the importance of radiologists communicating with sonographers in the diagnosis of APS.

摘要

目的

本研究旨在比较磁共振成像(MRI)与产前超声在异常胎盘形状(APS)中的特征。

方法

从胎盘植入谱系疾病(PAS)高发的 613 名女性初始队列中,回顾性分析了 27 名产前超声和 MRI 检查均发现 APS 的孕妇的 MRI 结果。以临床病理发现为金标准,评估产前 MRI 和诊断 APS 经验丰富的多学科团队的灵敏度、特异性和准确性。

结果

27 例 APS 患者中,包括帆状胎盘 14 例,双叶胎盘 8 例,环状胎盘 2 例,胎盘绒毛膜血管瘤、胎盘膜性、胎盘间质发育不良各 1 例。产前 MRI 对 APS 分类的灵敏度和特异性分别为 40.74%(11/27)和 97.65%(498/510)。然而,多学科团队的灵敏度和特异性高达 96.29%(26/27)和 99.22%(506/510)。

结论

我们证明了 MRI 和超声在 MRI 图像中检测胎盘形状方面的互补作用,突出了放射科医生与超声医师在 APS 诊断中进行沟通的重要性。

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