胎盘植入的MRI征象分析
MRI features of placenta accreta
目的 探讨胎盘植入的MRI征象.方法 回顾性分析2009年4月至2011年6月期间,经手术病理或临床诊断的15例胎盘植入患者资料,均行MR检查;选取同期因病情需要行MR检查,临床诊断无胎盘植入的孕妇15例作为对照组,分析两组间子宫变形和(或)异常隆凸、胎盘信号不均匀、T2WI低信号条带、胎盘内出血、胎盘下血管增多、胎盘下肌层变薄或消失情况,并采用Fisher精确概率检验进行比较.结果 15例胎盘植入组患者中,子宫变形和(或)局部隆凸14例,胎盘信号不均匀15例,胎盘内T2WI低信号条带15例,T1WI胎盘下血管增多11例,对照组分别是3、6、3和4例,差异均有统计学意义(P值分别为0.000、0.001、0.000和0.027).胎盘植入患者中,有子宫变形和异常隆凸、胎盘信号不均匀及T2WI低信号条带3种征象者共有14例,另1例仅有后2种征象,且该例有T1WI胎盘下血管增多.对照组中无一例同时有3种征象.结论 胎盘植入的MR征象主要包括子宫变形和(或)局部隆凸、胎盘信号不均匀、T2WI胎盘内低信号条带等,胎盘下血管增多,也可能是其重要征象.
更多Objective To investigate the MRI features of placenta accreta.Methods From Apr 2009 to Jun 2011,15 patients with placenta accrete received MRI examination.In them,placenta accrcta was diagnosed based on clinical manifestations or postoperative histopathologv.The MR features of placenta accreta in thcm( study group) were retrospectively analyzed and compared with those in 15 pregnant women without placenta accreta (control group)with Fisher exact test.Results In the 15 patients with placenta accreta,uterine bulging and(or) a focal outward contour bulge was detected in 14 patients; heterogeneous signal intensity in the placenta was detected in 15 patients; dark intraplacental bands on T2-weighted images was detected in 15 patients; and increased subplacental vascularity was detected in 11 patients on T1- weighted images.In the study group,14 patients showed at least three of the above four features,and in all of them uterine bulging and(or) a focal outward contour bulge,heterogeneous signal intensity in the placenta and dark intraplacental bands on T2-weighted images were detected; one patient showed heterogeneous signal intensity in the placenta,dark intraplacental bands on T2-weighted images and increased subplacental vascularity.In the control group,none patient had three of the above features.Uterine bulging and(or) a focal outward contour bulge,heterogeneous signal intensity in the placenta,dark intraplacental bands on T2-weighted images and increased subplacental vascularity were detected in 3,6,3 and 4 patients (P=0.000,0.001,0.000 and 0.027 ),respectively.Conclusions The main MRI features of placenta accreta are uterine bulging and(or) a focal outward contour bulge,heterogeneous signal intensity in the placenta and dark intraplacental bands on T2-weighted images Besides,increased subplacental vascularity also could provide useful information for the diagnosis of placenta accreta.
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