摘要
目的分析产前胎盘超声评分法联合核磁共振成像(MRI)对前置胎盘合并胎盘植入的诊断价值。方法选取2021年6月~2023年12月在中山市博爱医院产科门诊就诊的102例既往有剖宫产史或宫腔操作史、中晚孕期前置胎盘且疑似胎盘植入患者为研究对象,在晚孕期(≥28周)分别对所有研究对象进行产前胎盘超声、MRI检查。以病理诊断结果为金标准,分析胎盘超声评分法、MRI、胎盘超声评分+MRI(联合诊断)三种检查方式对前置胎盘合并胎盘植入的诊断价值。结果术后病理诊断结果显示,102例疑似胎盘前置合并胎盘植入患者中,66例确诊,36例为非胎盘前置合并胎盘植入患者;胎盘超声评分法诊断确诊63例胎盘前置合并胎盘植入患者;MRI诊断确诊62例,联合诊断确诊79例。三种检查方式对比,特异度、准确度、阳性预测值无明显差异(P>0.05),灵敏度、阴性预测值存在显著差异(P<0.05)。联合诊断的灵敏度、阴性预测值显著高于胎盘超声评分法、MRI诊断(P<0.05);联合诊断的准确度高于MRI诊断(P<0.05)。胎盘超声评分法、MRI诊断对比,灵敏度、特异度、准确度、阴性预测值均无显著差异(P>0.05)。ROC曲线分析结果表明,三种检查方式的AUC均>65%,联合诊断的AUC最大(81.23%)。结论产前胎盘超声评分法联合MRI对前置胎盘合并胎盘植入具有较高的诊断价值。
Objective To analyze the application diagnostic value of prenatal placental ultrasounographic score method combined with magnetic resonance imaging(MRI)in placenta previa complicated with placenta accreta.Methods From June 2021 to December 2023,102 patients with a history of cesarean section or uterine manipulation,placenta previa and suspected placenta accreta in the middle and late pregnancy who were treated in the obstetrics clinic of Zhongshan Bo'ai Hospital were selected as the study subjects.Prenatal placental ultrasonographic and MRI were performed on all subjects during late pregnancy(≥28 weeks).Taking the pathological diagnosis results as the gold standard,the diagnostic value of placental ultrasounographic score method,MRI,placental ultrasounographic score method+MRI(combined diagnosis)in placenta previa combined with placenta accreta was analyzed.Results Postoperative pathological diagnosis showed that among the 102 patients with suspected placental previa complicated with placenta accreta,66 cases were confirmed and 36 cases were non-placental previa complicated with placenta accreta.Placental ultrasonographic score method diagnosis confirmed 63 cases of placenta previa combined with placenta accreta,62 cases were diagnosed by MRI,and 79 cases were diagnosed by combined diagnosis.There were no significant differences in specificity,accuracy and positive predictive value among the three method(P>0.05),but there were significant differences in sensitivity and negative predictive value(P<0.05).The sensitivity and negative predictive value of combined diagnosis were significantly higher than those of placental ultrasonographic score method and MRI diagnosis(P<0.05).The accuracy of combined diagnosis was higher than that of MRI diagnosis(P<0.05).There were no significant differences in sensitivity,specificity,accuracy and negative predictive value between placental ultrasounographic score method and MRI diagnosis(P>0.05).The ROC curve showed that the AUC of the three methods were more than 65%,and the AUC of combined diagnosis was the largest(81.23%).Conclusion Prenatal placental ultrasounographic score method combined with MRI has a high diagnostic value for placenta previa and placenta accreta.
作者
王李洁
黄锦钊
伍诗媚
史妙丽
WANG Li-jie;HUANG Jin-zhao;WU Shi-mei(Department of Ultrasound,Zhongshan Bo'ai Hospital,Zhongshan 528403,China.;不详)
出处
《医师在线》
2024年第8期21-25,共5页
Journal of Doctors Online
基金
2021年度中山市第一批社会公益与基础研究项目(医疗卫生一般项目)(2021B1091)。
关键词
产前胎盘超声评分法
前置胎盘
胎盘植入
核磁共振成像
Prenatal placental ultrasonographic score method
Placenta previa
Placenta accreta
Magnetic resonance imaging
