| 陈文林,崔博闻,蔡思清.平扫MRI诊断早孕期剖宫产瘢痕妊娠发生胎盘植入[J].中国医学影像技术,2024,40(9):1382~1385 |
| 平扫MRI诊断早孕期剖宫产瘢痕妊娠发生胎盘植入 |
| Non-contrast MRI for diagnosing cesarean scar pregnancy developed placental implantation in early pregnancy |
| 投稿时间：2024-01-22 修订日期：2024-07-14 |
| DOI：10.13929/j.issn.1003-3289.2024.09.022 |
| 中文关键词: 胎盘,滞留 磁共振成像 |
| 英文关键词:placenta, retained magnetic resonance imaging |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨平扫MRI诊断早孕期剖宫产瘢痕妊娠(CSP)发生胎盘植入(PI)的价值。方法 回顾性收集79例早孕期CSP孕妇,根据术后病理,以瘢痕处肌层内存在绒毛组织或滋养细胞为发生PI(PI组,n=23)、以未见绒毛或滋养细胞为单纯CSP(CSP组,n=56);比较2组术前盆腔平扫MRI参数,评价MRI定量参数诊断早孕期CSP发生胎盘植入的效能。结果 相比CSP组,PI组孕囊最大面积及孕囊紧贴瘢痕长度更大、瘢痕最薄处厚度更小而瘢痕周围流空血管影占比更高(P均＜0.01)。以孕囊最大面积、孕囊紧贴瘢痕长度及瘢痕最薄处厚度诊断早孕期CSP发生PI的敏感度分别为78.26%、82.61%及91.07%,特异度分别为67.86%、66.07%及69.57%,其受试者工作特征曲线下面积分别为0.76、0.79及0.82;根据瘢痕周围流空血管影诊断的敏感度为78.26%(18/23)、特异度为85.71%(48/56)、准确率为83.54%(66/79)。结论 平扫MRI对诊断早孕期CSP发生PI具有重要临床价值。 |
| 英文摘要: |
| Objective To explore the value of non-contrast MRI for diagnosing cesarean scar pregnancy (CSP) developed placental implantation (PI) in early pregnancy. Methods Totally 79 pregnant women with CSP in early pregnancy were retrospectively enrolled. According to postoperative pathology, PI was diagnosed when villi tissue or trophoblast cells were found in the scar muscle (PI group, n=23), while single CSP was diagnosed when no villi nor trophoblast cells were detected in the scar muscle (CSP group, n=56). Preoperative non-contrast pelvic MRI parameters were compared between groups, and the efficacy of MRI quantitative parameters for diagnosing CSP developed PI in early pregnancy was evaluated. Results Compared with those in CSP group, the largest area of the pregnancy sac, the length of the pregnancy sac close to the scar were both larger, the thickness of the thinnest scar was smaller, and the proportion of empty blood vessels shadow around the scar was higher in PI group (all P＜0.01). The sensitivity of the largest area of the pregnancy sac, the length of the pregnancy sac close to the scar and the thickness of the thinnest scar for diagnosing CSP developed PI was 78.26%, 82.61% and 91.07%,respectively, and the specificity was 67.86%,66.07% and 69.57%,respectively, with area under the receiver operating characteristic curve of 0.76, 0.79 and 0.82,respectively. The sensitivity, specificity and accuracy of empty blood vessels shadow around the scar for diagnosing CSP developed PI was 78.26% (18/23), 85.71% (48/56) and 83.54% (66/79), respectively. Conclusion Non-contrast MRI had important clinical value for diagnosing CSP developed PI in early pregnancy. |
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