中国医学影像学杂志
中國醫學影像學雜誌
중국의학영상학잡지
CHINESE JOURNAL OF MEDICAL IMAGING
2015年
6期
474-477
,共4页
胎盘,侵入性%产前诊断%磁共振成像%误诊
胎盤,侵入性%產前診斷%磁共振成像%誤診
태반,침입성%산전진단%자공진성상%오진
Placenta accreta%Prenatal diagnosis%Magnetic resonance imaging%Diagnostic errors
目的胎盘植入为产科少见而危重的妊娠并发症，影像诊断较困难，本文旨在探讨产前胎盘植入的 MRI 表现及误诊原因。资料与方法回顾性分析经手术及病理证实的18例产前胎盘植入的 MRI 表现及分型。结果产前 MRI 疑诊15例（83.33%），表现为子宫壁明显变薄，结合带不连续，局部胎盘与子宫壁分界不清；胎盘内信号不均，可见 T2 HASTE 序列为极低信号、TruFISP 序列为高信号的增粗扭曲血管影及低信号条索影；胎盘后方可见 T1WI 高信号、T2WI 低信号血肿影。漏诊3例（16.67%）中，2例为粘连型，1例为植入型，产前 MRI 未能明确诊断。结论MRI 是诊断胎盘植入的辅助工具，MRI 对胎盘肌层植入及穿透的诊断准确率较高，而对粘连型植入诊断准确率较低。
目的胎盤植入為產科少見而危重的妊娠併髮癥，影像診斷較睏難，本文旨在探討產前胎盤植入的 MRI 錶現及誤診原因。資料與方法迴顧性分析經手術及病理證實的18例產前胎盤植入的 MRI 錶現及分型。結果產前 MRI 疑診15例（83.33%），錶現為子宮壁明顯變薄，結閤帶不連續，跼部胎盤與子宮壁分界不清；胎盤內信號不均，可見 T2 HASTE 序列為極低信號、TruFISP 序列為高信號的增粗扭麯血管影及低信號條索影；胎盤後方可見 T1WI 高信號、T2WI 低信號血腫影。漏診3例（16.67%）中，2例為粘連型，1例為植入型，產前 MRI 未能明確診斷。結論MRI 是診斷胎盤植入的輔助工具，MRI 對胎盤肌層植入及穿透的診斷準確率較高，而對粘連型植入診斷準確率較低。
목적태반식입위산과소견이위중적임신병발증，영상진단교곤난，본문지재탐토산전태반식입적 MRI 표현급오진원인。자료여방법회고성분석경수술급병리증실적18례산전태반식입적 MRI 표현급분형。결과산전 MRI 의진15례（83.33%），표현위자궁벽명현변박，결합대불련속，국부태반여자궁벽분계불청；태반내신호불균，가견 T2 HASTE 서렬위겁저신호、TruFISP 서렬위고신호적증조뉴곡혈관영급저신호조색영；태반후방가견 T1WI 고신호、T2WI 저신호혈종영。루진3례（16.67%）중，2례위점련형，1례위식입형，산전 MRI 미능명학진단。결론MRI 시진단태반식입적보조공구，MRI 대태반기층식입급천투적진단준학솔교고，이대점련형식입진단준학솔교저。
Purpose Placenta accreta is a rare but severe pregnancy complications, and imaging diagnosis is always difficult. This paper aims to analyze the MRI manifestations of placenta accreta, and explore its misdiagnosis reasons. Materials and Methods A retrospective study was carried out on the findings and classification of MRI plain scan and diffusion weighted imaging (DWI) scan of 18 patients with placenta accreta confirmed surgically and pathologically. Results The prenatal MRI scan reported 15 patients of placenta accreta correctly (83.33%), and missed 3 (16.67%) among which 2 were with placenta accreta and the other 1 with placenta increta. The MRI of placenta accreta presented rather thin muscular layer, discontinuous junctional zone, and some unclear boundary of placenta and uterine wall; the signal of the placenta was heterogeneous, and we could see enlarged vessels of extremely low signal on T2 HASTE and high signal on TruFISP sequences, and low signal of thick intraplacental band; moreover, hematoma with high intensity on T1WI and low intensity on T2WI could be seen. DWI demonstrated uneven intensity and dark thicker intraplacenta bands in 2 cases. Conclusion As an important clinical auxiliary tool in diagnosing placenta increta, MRI has high accuracy in the diagnosis of placenta increta and placenta percreta; however, it has rather low accuracy in placenta accreta.
