[摘 要] 目的 探讨磁共振成像（MRI）在产前胎盘植入诊断中的应用价值.方法 方便抽取2015年1月—2016年12月阶段在该院进行产前超声检查提示为胎盘植入或疑似胎盘植入的产妇130例作为研究对象,130例患者均行磁共振成像检查.130例患者均行剖宫产进行分娩,并进行术中诊断. 结果 130例产妇均行剖宫产进行分娩,其中60例经手术确诊为胎盘植入.60例胎盘植入产妇中,24例为粘连型、36例为植入型；16例为子宫前壁下段植入、4例为子宫前壁下段及切口植入、10例为子宫后壁下段植入、4例为子宫左侧壁植入、2例为子宫右侧壁植入.磁共振成像对胎盘植入诊断的灵敏度为90.9%,特异度为89.7%,阳性预测值为88.2%,阴性预测值为92.1%.胎盘粘连：其中4例表现出子宫壁结节状膨隆,占比16.7%；18例表现出子宫和胎盘交界面模糊,占比75.0%；8例表现出胎盘内低信号条索影,占比33.3%；12例表现出胎盘信号不均勻,占比50.0%.胎盘植入：32例表现出肌层和胎盘交界面毛躁,占比88.9%；20例表现出子宫肌层连续性中断,占比55.6%；34例表现出胎盘内信号不均匀,占比94.4%；36例表现出胎盘下可见低信号带,占比100.0%；4例表现出胎盘下出血,占比11.1%. 结论 磁共振成像在胎盘植入的临床诊断中具有较高的临床诊断准确率,诊断灵敏度和特异度也较高,是一项有效的胎盘植入诊断方式,可作为临床制定产前胎盘植入治疗方案的可靠依据.
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）12（b）-0185-03
[Abstract] Objective To study the application value of nuclear magnetic resonance in diagnosis of prenatal placenta implantation. Methods 130 cases of delivery women with placenta implantation and suspected with placenta implantation examined by the nuclear magnetic resonance in our hospital from January 2015 to December 2016 were convenient selected as the research objects and 130 cases of patients were examined by the nuclear magnetic resonance, and 130 cases of patients underwent the cesarean section for delivery, and intraoperative diagnosis. Results 130 delivery women underwent the cesarean section for delivery, including 60 cases were diagnosed with placenta implantation, of whom, there were 24 cases in adhesion type and 36 cases in implantation type, and there were 16 cases with anterior uterine wall lower segment implantation, 4 cases with anterior uterine wall lower segment and incision implantation, 10 cases with posterior uterine wall lower segment implantation, 4 cases with uterus left wall implantation, and 2 cases with uterus right wall implantation, and the sensitivity degree and specificity degree of nuclear magnetic resonance in diagnosis of prenatal placenta implantation were respectively 90.9% and 89.7%, and the positive predicative value and negative predicative value were respectively 88.2% and 92.1%, in terms of adherent placenta, 4 cases were with uterus wall nodules bulging, accounting for 16.7%, 18 cases showed blurred interface between uterus and placenta, accounting for 75.0%, 8 cases showed intraplacental low signal shadow, accounting for 33.3%, 12 cases showed that uneven placental signal, accounting for 50.0%, in terms of placenta implantation, 32 cases showed rough interface between myometrium and placenta, accounting for 88.9%, 20 cases showed the continuous interruption of myometrium, accounting for 55.6%, 34 cases showed the uneven intraplacental signal, accounting for 94.4%, 36 cases showed placental low signal band, accounting for 100.0%, and 4 cases showed placental hemorrhage, accounting for 11.1%. Conclusion The clinical diagnosis accurate rate, sensitivity degree and specificity degree of nuclear magnetic resonance in diagnosis of prenatal placenta implantation are high, which is an effective placenta implantation diagnosis way, and it can provide reliable basis for making the prenatal placenta implantation treatment plans.