磁共振成像在产前胎盘植入诊断中的临床价值

刘青 陈静静

[摘要] 目的 探討磁共振成像（MRI）在产前胎盘植入诊断中的临床价值。方法 方便选取126例于2016年2月—2017年6月在日照市人民医院磁共振室行产前检查疑有胎盘植入孕妇为研究对象，对其行MRI检查，将检查结果与手术或病理检查结果进行对比，并分析MRI的图像表现。结果 126例研究对象经手术或病理检查诊断78例存在胎盘植入，MRI检查诊断61例存在胎盘植入，诊断符合率为78.21%；相比于无胎盘植入者，存在胎盘植入的MRI图像表现主为子宫现不均匀增大及增厚现象，胎盘与子宫肌层边界模糊，形态不规则且组织内存在均匀实质信号，可见T2W1高信号或T1W1低信号，部分可见斑片状血灶，子宫肌层明显变薄，部分还存在胎盘组织侵入周围盆腔组织现象。 结论 磁共振成像技术在产前胎盘植入诊断中的准确率较高，且通过分析其图像表现，还可明确胎盘植入类型及胎盘和子宫内情况，以为后期治疗提供客观、可靠依据，具较高应用价值，值得在临床当中推广应用。

[关键词] MRI；胎盘植入；临床价值

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）02（a）-0020-03

The Clinical Value of Magnetic Resonance Imaging in the Diagnosis of Antenatal Placenta

LIU Qing1，2， CHEN Jing-jing3

1.The Affiliated Hospital of Qingdao University， Qingdao， Shandong Province， 266003 China； 2.MRI Room， Peoples Hospital of Rizhao， Rizhao， Shandong Province， 276800 China； 3. Radiology Department， the Affiliated Hospital of Qingdao University， Qingdao， Shandong Province， 266003 China

[Abstract] Objective This paper tries to explore the clinical effect of rehabilitation exercise after artificial hip replacement. Methods 126 cases were convenient selected from February 2016 to June 2017 in people's hospital of Rizhao of prenatal examination suspected placenta implanted pregnant women as the objects of study， adopting MRI examination， the results of the examination and surgical or pathological examination results were compared and analyzed by MRI image representation. Results 126 cases of the subjects by surgery or pathological examination of 78 cases of placental implantation， MRI examination of 61 cases of placental implantation， the diagnostic rate was 78.21%； Compared with those without placenta accreta， placenta accreta MRI images of the main performance of the existing uneven increase and thickening of the uterus， placenta and myometrium fuzzy boundaries， irregular shape and the organization there was a homogeneous real signal， visible T2W1 high signal or T1W1 low signal， part of the visible patchy blood fistula， myometrial thinning significantly， in part， there was the phenomenon of placental tissue invasion around the pelvic tissue. Conclusion Magnetic resonance imaging in the diagnosis of prenatal placenta accreta has the high accuracy， and by analyzing the image performance， the placenta accreta type and placenta and uterine conditions can be determined， to provide an objective and reliable treatment， with high application value， so it is worth to promote the application of clinical.

[Key words] MRI； Placenta implantation； Clinical value

胎盘植入是一种严重的产科并发症和危急重症，主因原发性蜕膜发育不良或是存在创伤性内膜缺陷，致胎盘绒毛侵入子宫肌层而引起[1]。近些年来，伴随人工流产及剖宫产率的不断上升，胎盘植入的发生率也不断上升。胎盘植入的发病突然且病情风险，会致产妇分娩时因胎盘剥离困难而引发产中或产后大出血，严重的还会引起继发性感染，甚至子宫破裂，不仅会危及产妇生命安全，而且也在很大程度上影响胎儿的顺利娩出[2]，因此，产前的胎盘植入诊断非常重要。……