论文部分内容阅读
目的探讨MRI对孕晚期胎盘异常的诊断价值。方法纳入41例孕妇,年龄22-41岁,平均年龄29岁,孕周30~38周,平均孕周35周。产前临床怀疑或超声提示胎盘异常且可行磁共振成像(MRI)检查,采用二维快速平衡稳态采集序列(2D FIESTA)、弥散加权序列(DWI)、三维容积内插快速扰相梯度回波序列(LAVA)或T1加权成像(T1WI)序列行子宫的常规横断面、矢状面及母体的冠状面扫描,将产前MRI表现与手术结果进行对照。结果 MRI结果显示41例孕妇中40例胎盘发现异常,漏诊胎盘粘连植入1例。前置胎盘30例,其中胎盘低置5例,边缘型前置胎盘4例,部分型前置胎盘6例,完全性前置胎盘15例;胎盘植入31例,胎盘剥离并血肿形成3例,2例为胎盘后剥离,1例为胎盘后及羊膜下剥离并血肿同时存在,胎盘内出血1例。超声诊断仅显示35例胎盘异常。结论 MRI在孕晚期胎盘异常诊断方面具有极高的应用价值。
Objective To investigate the diagnostic value of MRI for abnormal placenta in third trimester of pregnancy. Methods 41 pregnant women, aged 22-41 years old, mean age 29 years old, gestational weeks 30 to 38 weeks, the average gestational age of 35 weeks. Prenatal clinical suspicion or ultrasound showed placental abnormalities and feasibility of magnetic resonance imaging (MRI) examination, using two-dimensional fast steady homeostasis acquisition sequence (2D FIESTA), diffusion weighted sequence (DWI), three-dimensional volume interpolation fast spoiler gradient echo Serial (LAVA) or T1 weighted imaging (T1WI) sequences were routinely performed on the uterus in the transverse, sagittal and mammographic coronal planes to compare prenatal MRI findings with surgical findings. Results The results of MRI showed that 40 cases of 41 pregnant women had abnormal placenta and 1 case of missed placenta accreta. Placenta previa placenta in 4 cases, partial placenta previa in 6 cases, complete placenta previa in 15 cases, placenta accreta in 31 cases, placenta dissection and hematoma in 3 cases , 2 cases of post-placental dissection, 1 case of placenta and amniotic membrane detachment and hematoma exist, 1 case of placental hemorrhage. Ultrasound diagnosis showed only 35 cases of placental abnormalities. Conclusion MRI in the third trimester placental abnormal diagnosis has a very high value.