目的:探讨胎盘植入(placental adhesive disorders,PADs)MRI表现的特点及诊断价值。方法:回顾性分析我院2014年1月至2015年3月45例因经超声检查怀疑胎儿或胎盘异常行盆腔MRI检查患者的影像学及临床资料,其中30例经手术或病理证实为PADs。45例均行常规MRI扫描,2例行动态增强扫描。结果:MRI诊断PADs的灵敏度为87.1%(27/31),特异度为73.3%(11/15)。MRI检出PADs与手术及病理检查一致性分析结果显示,K=0.644,U=4.33,P=0.000,诊断符合率为84.4%(38/45),即一致性良好。MRI对PADs的检出率(90%)与超声(76.7%)比较差异无统计学意义(χ2=1.92,P=0.166)。胎盘粘连8例,PADs 20例,胎盘穿透肌层侵及膀胱后壁2例,其中,13例可见子宫肌层内或肌层与胎盘底蜕膜之间T2WI信号极低的增粗血管影。21例PADs患者合并完全前置胎盘。结论:MRI能明确诊断PADs、判断肌层侵入深度及范围,为临床产前诊断及治疗提供可靠依据。 Objective: To investigate the features and diagnostic value of MRI manifestations of placental adhesive disorders (PADs). Methods: The imaging and clinical data of 45 patients with suspected fetus or placenta accreta by pelvic MRI in our hospital from January 2014 to March 2015 were analyzed retrospectively. Among them, 30 cases were confirmed by operation or pathology as PADs. All 45 patients underwent conventional MRI scan and 2 patients underwent dynamic contrast-enhanced scan. Results: The sensitivity of MRI in diagnosing PADs was 87.1% (27/31) and the specificity was 73.3% (11/15). The coincidence analysis of PADs detected by MRI and pathology and operation showed that the coincidence rate was 84.4% (38/45) for K = 0.644, U = 4.33, P = 0.000, that is, the consistency was good. The detection rate of PADs by MRI (90%) was not significantly different from that of ultrasound (76.7%) (χ2 = 1.92, P = 0.166). There were 8 cases of placenta adhesion, 20 cases of PADs, 2 cases of invasion of placenta through the muscular layer and 2 cases of posterior wall of the bladder. Among them, thickened vessels with low T2WI signal were found in 13 cases of myometrium or myometrium and placental decidua . Twenty-one patients with PADs had complete placenta previa. Conclusion: MRI can confirm the diagnosis of PADs, determine the depth and extent of myometrial invasion, and provide a reliable basis for clinical prenatal diagnosis and treatment.