CAJ | 학술논문

目的：探讨 MRI 征象在诊断胎盘植入/穿透时的价值。方法回顾性分析39例产前超声怀疑胎盘植入/穿透而行 MRI检查的孕妇资料，以手术、病理结果作为金标准，将39例患者分为17例胎盘植入/穿透组和22例无胎盘植入的对照组，分析2组患者术前 MRI 上胎盘的特征性影像表现，采用二元 Logistic 回归进行单因素和多因素的分析。结果膀胱顶后壁幕状吊起或胎盘与邻近脏器境界不清，诊断胎盘穿透的 OR 值为70(P =0.008)；T2 WI 上胎盘内结节状低信号带和胎盘与肌层间条状低信号带内局部信号缺失，诊断胎盘植入的 OR 值分别为6.4(P =0.012)和5.6(P =0.025)。多因素分析时 T2 WI 上胎盘内结节状低信号带和胎盘与肌层间低信号带内局部信号缺失，诊断胎盘植入的 OR 值分别为6.6(P =0.02)和3.16(P =0.175)。结论膀胱顶壁幕状吊起及胎盘与邻近脏器境界不清对诊断胎盘穿透具有较高的价值。T2 WI 上胎盘内结节状低信号带对诊断胎盘植入具有较高的诊断价值。胎盘与肌层间条状低信号带内局部信号缺失对诊断胎盘植入具有提示作用。
목적：탐토 MRI 정상재진단태반식입/천투시적개치。방법회고성분석39례산전초성부의태반식입/천투이행 MRI검사적잉부자료，이수술、병리결과작위금표준，장39례환자분위17례태반식입/천투조화22례무태반식입적대조조，분석2조환자술전 MRI 상태반적특정성영상표현，채용이원 Logistic 회귀진행단인소화다인소적분석。결과방광정후벽막상조기혹태반여린근장기경계불청，진단태반천투적 OR 치위70(P =0.008)；T2 WI 상태반내결절상저신호대화태반여기층간조상저신호대내국부신호결실，진단태반식입적 OR 치분별위6.4(P =0.012)화5.6(P =0.025)。다인소분석시 T2 WI 상태반내결절상저신호대화태반여기층간저신호대내국부신호결실，진단태반식입적 OR 치분별위6.6(P =0.02)화3.16(P =0.175)。결론방광정벽막상조기급태반여린근장기경계불청대진단태반천투구유교고적개치。T2 WI 상태반내결절상저신호대대진단태반식입구유교고적진단개치。태반여기층간조상저신호대내국부신호결실대진단태반식입구유제시작용。
Objective To evaluate the predictive value of MRI features in the diagnosis of placenta increta/percreta preoperative-ly.Methods We retrospectively reviewed MRI of 39 pregnant women who were suspected to have placenta increta/percreta by the ultrasound previously.1 7 patients were defined as placenta increta/percreta according to the surgical-pathological results,while 22 patients were defined without abnormal placentation.We assessed the presence or absence of the specialized MRI features of placenta increta/percreta.The binary logistic regression analysis was used to determine the valuable MRI findings for predictive of placenta increta/percreta.Results The tenting of the superior wall of bladder or the infiltration of adjacent organs were the most useful signs to predict placenta percreta,with the highest odds ratio (OR)value of 70,P =0.008.The low signal intensity bands on T2 WI and focally interrupted interface of placenta/myometrial were valuable signs to the predictive of placenta increta,with the OR value of 6.4 and 5.6 respectively according to the univariate analysis.On multivariate regression analysis,the low signal intensity bands on T2WI was independent predictive factor for placenta increta(OR 6.6,P =0.02),while the focally interrupted interface of placen-ta/myometrial was not independent factor (OR 3.1 6,P =0.1 75).Conclusion The most useful predictive MRI features for placenta increta/percreta are tenting of the superior wall of bladder and the infiltration of adjacent organs,followed by the low signal intensity on T2 WI.The focally interrupted interface of placenta/myometrial is useful factor.