2015, Vol. 26 Issue (7): 505-508    DOI:
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产前超声与低场磁共振检查在胎盘植入诊断中的价值
王连云,谢爱兰,陈 伟,宋樟伟,王玉环
温州医科大学附属第二医院,浙江 温州 325027
The value of the ultrasonography and low-field MRI in the prenatal diagnosis of placenta increta
WANG Lian-yun, XIE Ai-lan, CHEN Wei, SONG Zhang-wei, WANG Yu-huan
The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou Zhejiang 325027, China
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摘要 目的:比较产前多普勒超声及低场磁共振检查对胎盘植入诊断的价值。方法:回顾性分析温州医科大学附属第二医院产科2006年1月—2014年1月收治的58例产后由临床和/或病理综合诊断证实为胎盘植入患者的临床资料,且所有患者产前均有多普勒超声及MRI检查了解胎盘情况,并与产后临床和/或病理综合诊断结果进行比较,分析多普勒超声与磁共振检查对产前胎盘植入诊断的敏感性和准确性。结果:58例胎盘植入患者中,多普勒超声诊断完全符合31例,符合率为53.4%(31/58),MRI诊断完全符合39例,符合率为67.2%(39/58),两种检查方法诊断符合率比较差异无统计学意义(P>0.05)。两种方法结合,诊断符合48例,符合率82.8%(48/58),三者诊断符合率比较差异有统计学意义(P<0.05)。胎盘位于后壁患者,多普勒超声诊断完全符合14例,符合率为43.8%(14/32),MRI诊断完全符合23例,符合率为57.1%(23/32),两种检查方法诊断符合率比较差异有统计学意义(P<0.05)。当多普勒超声出现胎盘增厚、胎盘后间隙消失等多种征象时,其诊断符合率为48.3%(28/58),单一征象往往难以确定为胎盘植入。当MRI出现直接征象时,其诊断符合率为53.4%(31/58);而间接征象的诊断符合率仅为13.8%(8/58),两者比较差异有统计学意义(P<0.05)。结论:MRI检查对胎盘位于子宫后壁的患者较多普勒超声更准确,可作为多普勒超声检查的重要补充。当多普勒超声出现多种征象、MRI出现直接征象时应考虑提示存在胎盘植入。
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王连云
谢爱兰
陈伟
宋樟伟
王玉环
关键词 胎盘疾病超声检查产前    
Abstract

Objective: To investigate the ultrasonography and low-field MRI in the prenatal diagnosis of placenta increta. Methods: Retrospective analyse 58 women diagnosed with placenta increta from January 2006 to January 2014 at affiliated Hospital of Wenzhou Medical University, all patients were confirmed by clinical and/or pathology after postpartum, and all were given Doppler ultrasound and MRI to monitor placental growth situation. The sensitivity and accuracy of Doppler ultrasonography and MRI for prenatal diagnosis of placenta increta were analysed. Results: In 58 patients with placenta increta, Doppler ultrasound diagnosis of 31 cases, coincidence rate was 53.4%(31/58), MRI diagnosis of 39 cases, coincidence rate was 67.2%(39/58). Two kinds of diagnostic methods have no statistical significance(P>0.05). Combined diagnosis coincidence rate was 82.8%(48/58). Three kinds of diagnostic methods have statistical significance(P<0.05). Patients with placenta are located in the back wall, Doppler ultrasound diagnosis of 14 cases, coincidence rate was 43.8%(14/32), MRI diagnosis coincidence rate was 57.1%(23/32). Two kinds of diagnostic methods have statistical significance(P<0.05). When the signs of thickening of the placenta, disappear of placenta back gap and so on were detected, the diagnosis coincidence rate was 48.3%(28/58), single sign was difficult to determine whether it was placenta implantation. When there were direct signs showed on MRI, the diagnosis coincidence rate was 53.4%(31/58), while the indirect signs of the diagnosis coincidence rate was only 13.8%(8/58), the difference was statistically significant(P<0.05). Conclusion: When placenta locates in the uterus back wall, MRI is more accurate than the Doppler ultrasound examination it can be used as an important supplement of the Doppler ultrasound examination. When many signs of placenta increta appeared on ultrasonography and direct signs appeared on MRI, it should be considered of placenta increta.

Key wordsPlacenta diseases    Ultrasonography    prenatal
收稿日期: 2014-12-05     
PACS:  R714.56  
  R445.1  
通讯作者: 王玉环   
引用本文:   
王连云;谢爱兰;陈 伟;宋樟伟;王玉环. 产前超声与低场磁共振检查在胎盘植入诊断中的价值[J]. , 2015, 26(7): 505-508.
WANG Lian-yun;XIE Ai-lan;CHEN Wei;SONG Zhang-wei;WANG Yu-huan. The value of the ultrasonography and low-field MRI in the prenatal diagnosis of placenta increta. , 2015, 26(7): 505-508.
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