知识与财富的链接
目的 评估MRI在孕晚期胎盘植入（PI）中的诊断价值。方法 回顾性分析临床疑似PI的87例孕晚期孕妇MRI资料,以术后病理为金标准,分别计算MRI对PI、不同分型（粘连型、植入型和穿透型）PI的诊断效能。采用行×列表χ2检验计算MRI征象在有无PI及不同PI类型间的关联性,并将有统计学意义的MRI征象与有无PI行Logistic回归分析。结果 经手术或病理证实57例为PI,MRI对产前PI诊断的敏感度和特异度分别为63.15%（36/57）、83.33%（25/30）。MRI诊断粘连型、植入型和穿透型PI的敏感度分别为46.51（20/43）、70.00（7/10）和50.00（2/4）。经Logistic回归分析显示原子宫切口显示及胎盘附着肌层变薄或缺失是预测PI的重要指标。结论 MRI判断有无PI具有较高的敏感度和特异度。原子宫切口显示及胎盘附着肌层变薄或缺失是预测PI的重要指标。
Objective To explore the value of MRI in diagnosis of placental increta (PI) in late pregnancy. Methods MRI findings in 87 pregnant women with suspected PI were evaluated. According to the surgical or pathological results, the efficiency of MRI for PI and PI types was calculated respectively. MRI findings between PI and non PI, as well as PI types were assessed by χ2 test. Associations between the statistically significant MRI signs with PI and non PI were calculated by Logistic regression analysis. Results Totally 57 women were confirmed PI according to the surgical or pathological results. The sensitivity and specificity of MRI in diagnosis PI were 63.15% (36/57) and 83.33% (25/30), and the sensitivity of MRI in diagnosis of accreta, increta, percreta PI was 46.51% (20/43), 70.00% (7/10) and 50.00% (2/4). Logistic regression analysis revealed that the original uterine incision display and thinning or focal defect of the uteroplacental interface were important indicator to predict the PI. Conclusion MRI has good sensitivity and specificity for the diagnosis of PI; the original uterine incision display and thinning or focal defect of the uteroplacental interface are important indicator to predict PI.
