摘要
目的观察两种影像技术(多普勒超声、MRI)在妊娠晚期前置胎盘诊断中的应用价值。方法选取2018年4月至2019年4月我院收治的222例疑似妊娠晚期前置胎盘患者为研究对象,均行彩色多普勒超声检查与MRI检查,评估其影像学特点,并将其与手术结果进行对照,分析多普勒超声、MRI的诊断价值。结果超声可见前置胎盘与子宫肌层或宫颈组织界限不清,缺乏蜕膜区域且该处探及丰富血流信号,MRI可见子宫不同程度增大,子宫内膜模糊、变薄,结合带不完整,病灶突入肌层,位于子宫后壁,T2WI序列上胎盘与子宫肌层间低信号带局部变薄或中断,穿透性植入者可见膀胱隆起或胎盘与腹盆腔正常脏器分界不清;手术确诊前置胎盘208例,MRI诊断前置胎盘的符合率97.60%(203/208)高于超声诊断75.00%(156/208)(P<0.05);以手术结果为准,MRI诊断植入型前置胎盘的灵敏度高于超声诊断,而特异度低于超声诊断(P<0.05),准确度比较差异无统计学意义(P>0.05)。结论多普勒超声与MRI在妊娠晚期前置胎盘中均有一定诊断价值,且MRI诊断符合率高,超声诊断有较高特异度,而MRI诊断灵敏度较好,有望将其联合提高诊断价值。
Objective To observe the application value of two imaging techniques(Doppler ultrasound,MRI)in the diagnosis of placenta previa in late pregnancy.Methods A total of 222 patients with suspected placenta previa in late pregnancy who were admitted to the hospital from April 2018 to April 2019 were enrolled in the study.All underwent color Doppler ultrasound and MRI.The imaging features were evaluated.And they were compared with surgical results.The diagnostic value of Doppler ultrasound and MRI was analyzed.Results Ultrasound showed that bound between placenta previa and myometrium or cervical tissue was unclear,lacking decidua area.There were abundant blood flow signals.MRI showed that uterus were increased to varying degrees.The endometrium was blurred and thinned.The combine belt was incomplete.The lesions protruded into muscular layer,located in uterus posterior wall.On T2WI sequence,low signal band between placenta and myometrium was locally thinned or interrupted.There were bladder bulge or unclear boundary between placenta and normal organs of abdominal pelvic cavity in penetrating implant patients.There were 208 cases with placenta previa confirmed by surgery.The coincidence rate of MRI for diagnosis of placenta previa was 97.60%(203/208),higher than that of ultrasound[5.00%(156/208)](P<0.05).Taking surgical results as standard,sensitivity of MRI for diagnosis of implantable placenta previa was higher than that of ultrasound,while specificity was lower than that of ultrasound(P<0.05).There was no significant differences in accuracy between the two methods(P>0.05).Conclusion Both Doppler ultrasound and MRI are of certain diagnostic value for placenta previa in late pregnancy.The coincidence rate of MRI diagnosis is high.The specificity of ultrasound diagnosis is relatively higher,while sensitivity of MRI diagnosis is relatively better.It is expected to combine them to improve diagnostic value.
作者
陈丽珍
CHEN Li-zhen(Department of Obstetrics,Central Hospital of Nanyang City,Nanyang 473000,Henan Province,China)
出处
《中国CT和MRI杂志》
2020年第10期116-118,173,共4页
Chinese Journal of CT and MRI
关键词
多普勒超声
MRI
妊娠晚期
前置胎盘
诊断
Doppler Ultrasound
MRI
Late Pregnancy
Placenta Previa
Diagnosis
