磁共振新征象评估穿透性胎盘植入的价值

【作者】 魏丽珍； 赖清泉； 黄芳； 吴宏； 李伟程； 黄文翰； 陈梅桂； 王毅；

【机构】 福建医科大学附属第二医院；

【摘要】 目的评估磁共振成像对预测穿透性胎盘植入的价值,建立基于其特征的logistic回归模型,并评估其诊断效能,协助临床精准诊断。方法回顾性分析127例经病理证实为胎盘植入患者的MRI影像及手术资料,其中100例用于构建回归模型,27例用作于模型外部数据来检验模型的准确性。由两名具有5年以上产科诊断经验的放射科医师采用里克特量表[1]给每个征象打分。结果胎盘隐窝胎、胎盘隆起Iia型、子宫浆膜血管增多是穿透性胎盘植入的独立危险因素。子宫与膀胱之间血管增多是膀胱受侵的独立预测因子。结论胎盘隐窝胎、胎盘隆起Iia型、子宫浆膜血管增多这三个征象对于鉴别穿透性胎盘植入有较大意义。子宫膀胱间隙血管增多是膀胱受侵的较为可靠的征象。更多还原

【Abstract】 Purpose: To evaluate the value of magneticresonance imaging in predicting penetrating placenta implantation, and a logistic regression model based on its characteristics was established to evaluate its diagnostic efficacy and assist in accurate clinical diagnosis. Materials and Methods: A retrospective analysis was made of 127 patients with placenta implantation confirmed by pathology. Among them, 100 cases were used to construct regression model and 27 cases were used to test the accuracy of the model with external data. Two radiologists with more than 10 years of experience in obstetric diagnosis scored each sign with the Richter scale [1]. Result: The specificity of placental recess, Iia type of placental protuberance and uterine serosal vascularization were significantly higher than those of other signs. The increase of blood vessels between uterus and bladder is an independent predictor of bladder invasion. Conclusions: The three signs of placental recess, Iia type of placental protuberance and increased uterine serosal vessels are of great significance in differentiating penetrating placenta implantation. Increased blood vessels in the space between uterus and bladder are reliable signs of bladder invasion.更多还原