摘要
目的探讨超声评分及MRI诊断凶险性前置胎盘(pernicious placenta previa)合并胎盘植入的临床应用及实用价值,提高临床诊断效能。方法收集2017年1月至2019年1月选择终止妊娠的孕晚期凶险性前置胎盘且考虑确诊为胎盘植入孕妇71例进行回顾性分析。终止妊娠术前分别给予超声诊断、产前MRI诊断、手术诊断(或病理诊断),以产前超声及MRI凶险性前置胎盘并植入诊断指标进行观察,分析图像特点,依次进行上述两种方法进行灵敏度、特异度及准确性的比较。结果2种方法证实71例孕妇均诊断为凶险性前置胎盘,经术后病理证实超声评分对凶险性前置胎盘合并胎盘植入诊断灵敏度76.09%,特异度64.00%,准确率86.4%;MRI诊断植入型33例,非植入型15例,灵敏度为71.74%(33/45),特异度为60.00%(16/25),准确率90.65%,二者比较差异无统计学意义(P>0.05)。结论超声评分及MRI均可用于凶险性前置胎盘合并胎盘植入产前术前诊断评估,且灵敏度及特异度无显著差异,但超声评分具备重复性高、价格低、准确率高等优势,因此作为诊断凶险性前置胎盘的首选检查;MRI作为超声评分的有效补充,必要时可将二者联合应用。
Objective To investigate the clinical application and practical value of ultrasound scoring and MRI in the diagnosis of pernicious placenta previa(PPP)combined with placenta accreta,so as to improve the diagnostic efficiency in clinical practice.Methods The clinical data of 71 pregnant women with PPP who chosed to terminate pregnancy in our hospital from January 2017 to January 2019 were retrospectively analyzed.Before the termination of pregnancy,ultrasound diagnosis,prenatal MRI diagnosis,and surgical diagnosis(or pathological diagnosis)were performed.Prenatal ultrasound and MRI were used to observe the diagnostic indexes for PPP.The image characteristics were sorted and analyzed.Moreover the sensitivity,specificity and accuracy of the above two methods were compared.Results The two methods confirmed the diagnosis of PPP in 71 pregnant women.The sensitivity,specificity and accuracy of ultrasound scoring in diagnosis of PPP combined with placenta implantation confirmed by postoperative pathology were 76.09%,64.00%,and 86.4%,respectively.MRI confirmed that there were 33 cases of placenta implantation and 15 vases of non-placenta implantation,with the sensitivity,specificity and accuracy being 71.74%(33/45),60.00%(16/25),and 90.65%,respectively.There were no significant differences between the two methods(P>0.05).Conclusion Both ultrasound scoring and MRI can be used for prenatal diagnosis and evaluation of PPP combined with placenta implantation,and there are no significant differences in sensitivity and specificity between the two diagnosis methods.However,ultrasound scoring has the advantages of high repeatability,low price,and high accuracy,therefore,it is the first choice in the diagnosis of PPP.
作者
张金辉
张桂欣
张宇
孟雁欣
易建平
ZHANG Jinhui;ZHANG Guixin;ZHANG Yu(Department of Ultrasound Diagnosis,Tangshan Hospital for Maternal and Child Health,Hebei,Tangshan 063000,China)
出处
《河北医药》
CAS
2021年第9期1339-1342,共4页
Hebei Medical Journal
基金
河北省科学技术研究与发展计划项目(编号:17277705D)。
关键词
超声评分
凶险性前置胎盘
胎盘植入
磁共振成像
ultrasound scoring
dangerous placenta previa
placenta implantation
magnetic resonance imaging
