中国临床医学
中國臨床醫學
중국림상의학
Chinese Journal of Clinical Medicine
2015年
5期
679-683
,共5页
磁共振成像%胎盘植入%前置胎盘%快速成像序列
磁共振成像%胎盤植入%前置胎盤%快速成像序列
자공진성상%태반식입%전치태반%쾌속성상서렬
Magnetic resonance imaging%Placenta implantation%Placenta previa%Fast imaging sequence
目的：探讨磁共振（M RI）快速成像序列对前置胎盘、产前胎盘植入的诊断价值。方法：选择2012年6月—2014年6月因超声诊断前置胎盘或怀疑胎盘植入而进一步进行M RI检查的孕妇131例，对其诊断结果进行分类总结。M RI序列采用平衡式快速梯度回波（B‐FFE）和单次激发快速自旋回波（SS‐TSE）。结果：131例孕妇MRI图像质量满意。分娩后手术及病理诊断胎盘植入43例，其中3例为单纯胎盘植入，40例为前置胎盘合并胎盘植入；17例为粘连性胎盘植入，26例为植入性和穿透性胎盘植入。M RI准确诊断植入性和穿透性胎盘植入22例（22／26，84．62％），假阳性5例，漏诊（假阴性）4例，灵敏度为84．62％；M RI准确诊断粘连性胎盘植入14例（14／17，82．35％），假阳性3例，漏诊（假阴性）3例，灵敏度82．35％；M RI产前检查诊断胎盘植入的灵敏度、特异度、诊断符合率、阳性预测值、假阳性率、假阴性率分别为83．72％、90．91％、88．55％、81．82％、9．09％、16．28％。M RI对前置胎盘分型的符合率为100％。结论：M RI快速成像序列对胎盘位置异常具有较高的诊断价值，是对胎盘位置异常进行定位及定性的重要验证和补充手段。
目的：探討磁共振（M RI）快速成像序列對前置胎盤、產前胎盤植入的診斷價值。方法：選擇2012年6月—2014年6月因超聲診斷前置胎盤或懷疑胎盤植入而進一步進行M RI檢查的孕婦131例，對其診斷結果進行分類總結。M RI序列採用平衡式快速梯度迴波（B‐FFE）和單次激髮快速自鏇迴波（SS‐TSE）。結果：131例孕婦MRI圖像質量滿意。分娩後手術及病理診斷胎盤植入43例，其中3例為單純胎盤植入，40例為前置胎盤閤併胎盤植入；17例為粘連性胎盤植入，26例為植入性和穿透性胎盤植入。M RI準確診斷植入性和穿透性胎盤植入22例（22／26，84．62％），假暘性5例，漏診（假陰性）4例，靈敏度為84．62％；M RI準確診斷粘連性胎盤植入14例（14／17，82．35％），假暘性3例，漏診（假陰性）3例，靈敏度82．35％；M RI產前檢查診斷胎盤植入的靈敏度、特異度、診斷符閤率、暘性預測值、假暘性率、假陰性率分彆為83．72％、90．91％、88．55％、81．82％、9．09％、16．28％。M RI對前置胎盤分型的符閤率為100％。結論：M RI快速成像序列對胎盤位置異常具有較高的診斷價值，是對胎盤位置異常進行定位及定性的重要驗證和補充手段。
목적：탐토자공진（M RI）쾌속성상서렬대전치태반、산전태반식입적진단개치。방법：선택2012년6월—2014년6월인초성진단전치태반혹부의태반식입이진일보진행M RI검사적잉부131례，대기진단결과진행분류총결。M RI서렬채용평형식쾌속제도회파（B‐FFE）화단차격발쾌속자선회파（SS‐TSE）。결과：131례잉부MRI도상질량만의。분면후수술급병리진단태반식입43례，기중3례위단순태반식입，40례위전치태반합병태반식입；17례위점련성태반식입，26례위식입성화천투성태반식입。M RI준학진단식입성화천투성태반식입22례（22／26，84．62％），가양성5례，루진（가음성）4례，령민도위84．62％；M RI준학진단점련성태반식입14례（14／17，82．35％），가양성3례，루진（가음성）3례，령민도82．35％；M RI산전검사진단태반식입적령민도、특이도、진단부합솔、양성예측치、가양성솔、가음성솔분별위83．72％、90．91％、88．55％、81．82％、9．09％、16．28％。M RI대전치태반분형적부합솔위100％。결론：M RI쾌속성상서렬대태반위치이상구유교고적진단개치，시대태반위치이상진행정위급정성적중요험증화보충수단。
Objective:To explore the diagnostic value of fast imaging sequence of Magnetic Resonance Imaging (MRI) in placenta previa and prenatal placenta implantation .Methods:A total of 131 cases of pregnant women ,who had been diagnosed with placenta previa or suspected placenta implantation by ultrasonography and then underwent further MRI examination during June 2012 and June 2014 ,were enrolled ,and the diagnosis results were classified and summarized .MRI sequences included balanced fast field echo (B‐FFE) and single shot turbo spin echo (SS‐TSE) .Results:Quality of MRI images of 131 pregnant women was satisfactory .After childbirth ,43 cases were diagnosed as placenta implantation by surgery and pathology ,of which 3 cases were simple placenta implantation and 40 cases were placenta implantation combined with placenta previa .Among the 43 cases ,17 cases were adhesive placenta implantation ,and the other 26 cases were implantable and penetrative placenta implantation .Totally 22 cases with implantable and penetrative placenta implantation were diagnosed accurately (22/26 , 84 .62% ) by MRI ,while 5 cases were false positive and 4 cases were missed (false negative) ,thus the sensitivity was 84 .62% .Totally 14 cases with adhesive placenta implantation were diagnosed accurately by MRI(14/17 ,82 .35% ) ,while 3 cases were false positive ,thus the sensitivity was 82 .35% .The sensitivity ,specificity ,diagnostic accordance rate ,positive predictive value ,false positive rate ,and false negative rate of prenatal MRI examination for diagnosing placenta implantation were 83 .72% ,90 .91% ,88 .55% ,81 .82% ,9 .09% ,and 16 .28% ,respectively .Accordance rate of MRI for differentiating types of placenta previa was 100% .Conclusions:Fast imaging sequence of MRI has a high diagnostic value for abnormal location of placenta ,and it is an important verification and supplementary measure for positioning and determining abnormal placenta location .
