| 朱晓曼,张军.MRI诊断胎盘植入[J].中国医学影像技术,2016,32(3):416~420 |
| MRI诊断胎盘植入 |
| MRI in diagnosis of placenta accreta |
| 投稿时间：2015-07-14 修订日期：2016-01-06 |
| DOI：10.13929/j.1003-3289.2016.03.025 |
| 中文关键词: 胎盘植入 磁共振成像 |
| 英文关键词:Placenta invasion Magnetic resonance imaging |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨MRI对胎盘植入的诊断价值及其主要影像学表现。方法 收集65例具有胎盘植入高危因素的患者,均行MR检查,记录诊断结果,并与手术或病理结果进行对照分析。评估MRI预测胎盘植入以及采用各MRI征象诊断的效能,并绘制ROC曲线、计算曲线下面积(AUC);应用Kappa检验评价MRI与手术或病理分型诊断的一致性。结果 65例患者中,手术或病理证实为胎盘植入者30例,其中粘连型12例,植入型16例,穿透型2例;35例无胎盘植入。MRI诊断胎盘植入的敏感度为73.33%(22/30),特异度为85.71%(30/35),准确率为80.00%(52/65)。预测胎盘植入的最佳MRI征象为子宫肌层与胎盘局部分界不清,AUC为0.817。MRI诊断粘连型胎盘的Youden指数最低(0.42),诊断植入型胎盘诊断的Youden指数最高(0.71)。MRI对胎盘植入分型与手术或病理分型结果的一致性较好(Kappa=0.607,P<0.05)。结论 采用MRI对胎盘植入进行诊断及分型时,可显示多种相关征象,具有重要价值,其中子宫肌层与胎盘局部分界不清为预测胎盘植入的最佳MRI征象。 |
| 英文摘要: |
| Objective To explore the MRI manifestations of placenta invasion and diagnostic value. Methods Totally 65 pacients who had risk of placenta invasion underwent MR examination, the results were recorded and compared to the surgical or pathological results. The efficiency of MRI and each signs of predicting placenta invasion were evaluated by ROC curve and the area under the curve(AUC) were calculated. The consistence between MRI results and surgical or pathological results were evaluated by Kappa test. Results In 65 cases, 30 cases were confirmed to be placenta invasion by surgery or pathology, including 12 cases of placenta accreta, 16 cases of placenta inccreta and 2 cases of placneta percreta, and 35 cases were confirmed to be normal. The sensitivity, specificity and accuracy of MRI were 73.33%(22/30), 85.71%(30/35) and 80.00%(52/65). The best MRI sign to predict placenta invasion was that there was no clear boundary between myometrium and placenta(AUC=0.817). The Youden index of MRI in diagnosis of placenta accrete was lowest(Youden index=0.42), and the highest was in diagnosis of placenta percreta(Youden index=0.71). There was good consistence between MRI results and surgical or pathological results in the diagnosis of placenta invasion(Kappa=0.607, P<0.05). Conclusion MRI can be used to show multiple signs and has a high value in diagnosis and classification of placenta invasion, and the best sign is that there is no clear boundary between myometrium and placenta. |
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