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目的 :探讨DWI成像对于各型胎盘植入的诊断价值,并与常规T2WI对比,分析其诊断效能。材料与方法 :选取我院2011年6月至2014年8月胎盘植入患者共45例进行常规T2WI和DWI扫描,其中DWI分别使用b值0s/mm~2、500s/mm~2、1000s/mm~2三个扫描参数。采用方差分析的方法比较各b值组之间胎盘植入区域与子宫肌壁区域的信号强度比(SI Ratio),然后以病理诊断为标准,选取具有最高SI Ratio的b值组与常规T2WI对比,分析其对于三种病理类型胎盘植入的诊断效能。结果 :45例患者中12例为粘连性胎盘,21例为植入性胎盘,12例为穿透性胎盘。当b值选取1000s/mm~2时,胎盘植入区域与子宫肌壁区域的SI Ratio最高(5.87±1.25),与b值0s/mm~2及500s/mm~2相比,差异有统计学意义。当b值为1000s/mm~2时,DWI图像对于粘连性胎盘,并不比常规T2WI好,但是对于植入性胎盘和穿透性胎盘,DWI明显好于常规T2WI。结论 :当b值选取1000s/mm~2时,DWI对于胎盘植入具有较高的显示效果,比常规T2WI更具有临床诊断价值,为临床治疗提供可靠的依据。
OBJECTIVE: To investigate the diagnostic value of DWI imaging for placenta accreta and to compare its diagnostic efficacy with conventional T2WI. Materials and Methods: Totally 45 patients undergoing placental implantation from June 2011 to August 2014 in our hospital underwent conventional T2WI and DWI scanning. Among them, DWI were performed with b values of 0s / mm ~ 2,500s / mm ~ 2,1000s / mm ~ 2 three scanning parameters. The ANOVA method was used to compare the SI ratio between placenta accreta and uterine muscular wall in each b-value group. Then, the pathological diagnosis was used as the standard, and the b-value group with the highest SI Ratio was compared with the conventional T2WI , Analyzed its diagnostic efficacy for three pathological types of placenta accreta. RESULTS: Twelve of 45 patients had adhesive placenta, 21 had placenta accreta and 12 had penetrating placenta. When the value of b was 1000s / mm ~ 2, the SI ratio of placenta implantation and uterine muscular wall was the highest (5.87 ± 1.25), which was statistically different from 0s / mm ~ 2 and 500s / mm ~ 2 Significance of learning. When the b value is 1000s / mm ~ 2, the DWI images are not better than the conventional T2WI for the adhesive placenta, but the DWI is obviously better than the conventional T2WI for the implantable placenta and the penetrating placenta. CONCLUSION: When the b value is 1000s / mm ~ 2, DWI has a higher display effect on placenta accreta and has more clinical diagnostic value than conventional T2WI, which can provide a reliable basis for clinical treatment.