CAJ | 학술논문

目的：探讨 MRI对前置胎盘和胎盘前置状态及伴发的胎盘植入的诊断价值。方法：搜集本院25例前置胎盘和胎盘前置状态孕妇的临床及影像学资料，年龄21～43岁，平均（29．4±6．2）岁，孕龄21～38周，平均（32．9±4．0）周，25例均行产前 MRI及超声（US）检查，以病理或分娩时临床诊断为金标准，对比分析两种检查的诊断价值。结果：25例前置胎盘和胎盘前置状态孕妇中，中央性19例，部分性3例，边缘性3例，MRI与US分别正确诊断20例、18例，两者对前置胎盘的诊断及分型差异无统计学意义（P＞0．05）。MRI诊断前置胎盘伴发胎盘植入敏感度71．4％，特异度72．7％，阳性预测值76．9％，阴性预测值66．7％；US诊断伴发胎盘植入敏感度66．7％，特异度69．2％，阳性预测值66．7％，阴性预测值69．2％。胎盘植入的 MRI表现主要有子宫底蜕膜信号缺失，子宫肌层局部变薄，胎盘与子宫交界面可见结节样改变，胎盘信号不均匀，在T2 WI上胎盘内可见低信号带，胎盘与膀胱之间组织间隙减小或消失等。结论：MRI 和 US 对前置胎盘或前置状态伴发胎盘植入有重要价值，两者可相互补充。
목적：탐토 MRI대전치태반화태반전치상태급반발적태반식입적진단개치。방법：수집본원25례전치태반화태반전치상태잉부적림상급영상학자료，년령21～43세，평균（29．4±6．2）세，잉령21～38주，평균（32．9±4．0）주，25례균행산전 MRI급초성（US）검사，이병리혹분면시림상진단위금표준，대비분석량충검사적진단개치。결과：25례전치태반화태반전치상태잉부중，중앙성19례，부분성3례，변연성3례，MRI여US분별정학진단20례、18례，량자대전치태반적진단급분형차이무통계학의의（P＞0．05）。MRI진단전치태반반발태반식입민감도71．4％，특이도72．7％，양성예측치76．9％，음성예측치66．7％；US진단반발태반식입민감도66．7％，특이도69．2％，양성예측치66．7％，음성예측치69．2％。태반식입적 MRI표현주요유자궁저세막신호결실，자궁기층국부변박，태반여자궁교계면가견결절양개변，태반신호불균균，재T2 WI상태반내가견저신호대，태반여방광지간조직간극감소혹소실등。결론：MRI 화 US 대전치태반혹전치상태반발태반식입유중요개치，량자가상호보충。
Objective:To assess the value of MRI in the diagnosis of placenta previa as well as accompanying placenta accreta.Methods:The clinical and imaging materials of 25 pregnant patients with placenta previa were included in this stud-y,the age ranged from 21~43y (mean,29.4±6.2y),the gestational age of the fetuses at the time of MRI ranged from 21~38w (mean,32.9±4.0w).All patients underwent MR and ultrasonography (US)before delivery.Taking pathology and the final clinical diagnosis during delivery as gold standard,the value of these two imaging modalities were compared and ana-lyzed.Results:Among the 25 pregnant women with placenta previa,there were central complete type (19 cases),partial type (3 cases)and marginal type (3 cases).MRI and US correctly diagnosed 20 cases and 18 cases respectively,with no signifi-cant statistic difference (P>0.05).The sensitivity and specificity of MRI and US for accompanying placenta accreta was 71.4%,66.7% and 72.7%,69.2%,respectively;the negative predictive value (NPV)and positive predictive value (PPV) was 76.9%,66.7% and 66.7%,69.2%,respectively.On MRI,the placenta accreta demonstrated partial loss of deciduum, focal thinness or absence of myometrium,nodular interface between placenta and uterus,heterogeneous signal intensities within placenta,bands of hypo-intensities within placenta on T2 WI,loss or diminish of the inter-space between placenta and bladder.Conclusion:MRI and US play an important role in the diagnosis of placenta previa and accompanying placenta accre-ta,they are complementary.