【摘要】 目的 探讨基于多模态MRI征象构建的列线图模型对胎盘植入性疾病(PAS)发生不良妊娠结局的预测价值。方法 收集60例经术中和/或病理诊断为PAS患者的临床及MRI资料。采用多因素logistic回归分析PAS发生不良妊娠结局的独立危险因素。根据多因素logistic回归分析结果,构建PAS发生不良妊娠结局的列线图预测模型。结果 胎盘/子宫膨出[比值比(OR)=6.717,P=0.015]、胎盘内异常血管(OR=7.929,P=0.009)、扩散加权成像(DWI)胎盘钉状/结节状突入肌层(OR=12.134,P=0.003)是PAS发生不良妊娠结局的独立危险因素。基于此结果构建列线图预测模型,该模型预测PAS发生不良妊娠结局的曲线下面积(AUC)为0.907,敏感度0.906,特异度0.821。结论 基于多模态MRI征象构建的列线图模型对PAS发生不良妊娠结局的预测有一定价值。更多还原

【Abstract】 Objective To explore the predictive value of the nomogram model based on multimodal MRI signs for adverse pregnancy outcomes in placenta accreta spectrum disorders(PAS).Methods The clinical and MRI data of 60 patients with PAS diagnosed by surgery and/or pathology were collected.Multivariate logistic regression was used to analyze the independent risk factors of adverse pregnancy outcomes in PAS.According to the results of multivariate logistic regression analysis,the nomogram prediction model of adverse pregnancy outcomes in PAS was constructed.Results Placenta/uterine protrusion[odds ratio(OR)=6.717,P=0.015],abnormal blood vessels in the placenta(OR=7.929,P=0.009),and diffusion weighted imaging(DWI) placental spike/nodular protrusion into the muscular layer(OR=1 2.1 34,P=0.003) were independent risk factors for adverse pregnancy outcomes in PAS.Based on the results,a nomogram prediction model was constructed.The area under the curve(AUC) of the model for predicting adverse pregnancy outcomes of PAS was 0.907,with a sensitivity of 0.906 and a specificity of 0.821.Conclusion The nomogram model constructed based on multimodal MRI signs has certain value in predicting adverse pregnancy outcomes of PAS.更多还原