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1、凶险型前置胎盘产前彩超与MRI诊断价值比[摘要]目的比较彩超和MRI在凶险型前置胎盘产前诊断中的价值。方法对20例疑诊凶险型前置胎盘患者分别进行彩超和MRI检查,与手术及病理结果作为金标准进行比较,对比两组诊断结果。结果经手术或病理证实20例患者中凶险型前置胎盘共8例。彩超组误诊1例,漏诊3例,符合率为87.54%;MRI组误诊1例,漏诊1例,符合率为88.78%,差异无显著性意义(P>0.05)。结论彩超、MRI都是诊断凶险型前置胎盘的适宜方法,但MRI在对合并后壁胎盘植入的凶险型前置胎盘灵敏度高,漏诊率低。在彩超诊断不明确患者,可联
2、合MRI检查,有望提高凶险型前置胎盘的产前诊断率,为临床治疗提供诊断信息。[关键词]彩超;磁共振;凶险型前置胎?诊断[中图分类号]R714[文献标识码]B[文章编号]2095-0616(2013)22-10-02ThevalueofcolorDopplerultrasoundandMRIinthediagnosisofperniciousplacentapreviaLIUXiangpinglWANGJinglYANGXiaowenlSUChunhong2ZHANGZhifei31.DepartmentofObstetrics,Pingx
3、iangPeople'sHospital,Pingxiang337055,China;2.DepartmentofObstetrics,theThirdAffiliatedHospitalofGuangzhouMedicalCollege,Guangzhou510150,China;3.DepartmentofPhysiologyandPathophysiology,CapitalMedicalUniversity,Beijing100069,China[Abstract]ObjectiveToassessthevalueofcolor
4、dopplerultrasoundandMRIinthediagnosisofperniciousplacentaprevia・Methods20caseofsuspectedperniciousplacentapreviawerediagnosedandanalyzedbyultrasoundretrospectivelyandMRI,respectively.ResultsAmongthe20casesconfirmedbyclinicalandpathologica.1,8caseswereperniciousplacentapr
5、evia・Whenanalyzedbyultrasoundretrospectively,onecaseswasfalsepositive,andthreecasesweremissed,theaccuracyratewas87.54%.WhendiagnosedbyMRI,onecasewasfalsepositive,andonecasewasmissed,theaccuracyratewas88.78%・Therewasnosignificantdifferencebetweenthetwogroupsofpatients(P>0
6、.05).ConclusionUltrasoundandMRIaresuitablemethodstogotdefinitelyprenataidiagnosisofperniciousplacentaprevia・BecauseMRImightbemoreeffectiveinthediagnosisofplacentaaccretaoccuringontheposteriorwallsoftheuterus,combinedwithUltrasoundandMRIareexpectedtoimprovetherateofprenat
7、aldiagnosisandhelptomakeclinicaldecision.[Keywords]ColorDopplerultrasound;Magneticresonanceimaging(MRI);Perniciousplacentaprevia;Diagnosis凶险型前置月台盘(perniciousplacentaprevia)是严重的妊娠并发症之一,因产前诊断困难,可造成孕产妇大量出血,是子宫切除的重要原因,严重危及产妇及胎儿的生命安全。目前产前诊断凶险型前置胎盘主要有彩超、磁共振(MRI)、血清甲胎蛋白(AFP)及内镜
8、检查。AFP特异性不高,内镜检查仅适用于胎盘植入累及膀胱或乙状结肠时。本研究主要探讨彩超、MRI对凶险型前置胎盘的诊断价值。1资料与方法1.1一般资料选择2010年9月〜2012年9月于江西省萍乡人民医院及