彩色多普勒超声与MRI对胎盘植入产前诊断价值的比较

摘要

Objective:To evaluate the diagnostic value of color Doppler prenatal ultrasound and magnetic resonance(MRI) imaging of placenta accreta. Method:Selecting 2011-2013 in the hospital at the same time for prenatal color Doppler ultrasound and magnetic resonance imaging were performed in 35 patients suspected of placenta accreta postpartum patients,diagnosed by pathological examination,reliability and to compare the difference between two methods for the diagnosis of placenta accreta;summary of placenta implantation image characteristics of color doppler ultrasound and magnetic resonance imaging.Result:35 cases of suspected patients with pathologically confirmed placenta implanted 12 patients;ultrasound examinations showed positive in 12 and negative in 23 cases, misdiagnosis 1 case,missed 1 case;MRI examination revealed 11 cases of placenta accreta positive ,negative 24 cases,misdiagnosis 1 case,missed 2 cases. Statistical analysis showed that ultrasound and MRI Kappa values were 0.87 and 0.75 (all>0.4 );compare the two methods,both in the sensitivity,specificity, precision than diagnosing index difference was not statistically significant(P>0.05).Conclusion:Ultrasound and MRI as the main means of clinical prenatal diagnosis of placenta accreta ,its diagnostic value worthy of recognition ,but ultrasound and MRI diagnosis of placenta accreta can not replace each other,should combine their features and characteristics of positive cases found comprehensive diagnosis.%目的：探讨彩色多普勒超声和核磁共振(MRI)成像对胎盘植入的产前诊断价值。方法：选取2011-2013年于笔者所在医院同时进行产前彩色多普勒超声与磁共振成像检查35例疑诊胎盘植入患者，产后经病理检查确诊，比较两种方法对胎盘植入诊断的可靠性和差异性；总结彩色多普勒超声和磁共振成像的胎盘植入图像特点。结果：35例疑似患者中经病理检查确诊胎盘植入患者12例；彩超检查提示阳性12例，阴性23例，误诊1例，漏诊1例；MRI检查提示胎盘植入阳性11例，阴性24例，误诊1例，漏诊2例。统计分析发现彩超和MRI的Kappa值分别为0.87和0.75(均>0.4)；两种方法进行比较，敏感性、特异性、精确比、诊断指数等方面比较差异无统计学意义(P>0.05)。结论：彩超和MRI作为目前临床产前诊断胎盘植入的主要手段，其诊断价值值得肯定，但彩超与磁共振对胎盘植入的诊断不可相互替代，应该结合各自的特征及发现的阳性病例特点进行综合作出诊断。