河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (2): 203-207,240.doi: 10.3969/j.issn.1007-3205.2023.02.016

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基于MRI、彩色超声检测技术评价穿透性凶险型前置胎盘的影像特征及预测价值

  

  1. 河北省唐山市妇幼保健院产科，河北 唐山063000

  • 出版日期:2023-02-25 发布日期:2023-02-28
  • 作者简介:秦聪颖（1989-），女，河北滦县人，河北省唐山市妇幼保健院主治医师，医学硕士，从事产科危重型疾病诊治研究。
  • 基金资助:
    河北省重点研发计划自筹项目（172777165）

Evaluation of imaging features and predictive value of penetrating and pernicious placenta previa based on MRI and color Doppler ultrasonography

  1. Department of Obstetrics, Maternity and Child Care Hospital of Tangshan City, Hebei Province, Tangshan 063000, China
  • Online:2023-02-25 Published:2023-02-28

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摘要： 目的 探讨基于磁共振成像（magnetic resonance imaging，MRI）、彩色多普勒超声检测技术评价穿透性凶险型前置胎盘（pernicious placenta previa，PPP）的影像特征及预测价值。
方法 选取我院收治的70例PPP孕产妇为研究对象，均进行MRI、彩色超声检测。分析MRI、彩色超声检测技术单项和联合对PPP的诊断价值；比较非穿透性PPP和穿透性孕产妇MRI、彩色超声特征；分析穿透性PPP孕产妇预后影响因素，采用受试者工作特征曲线评价MRI、彩色超声评分对穿透性PPP孕产妇预后的预测价值。
结果 70例PPP患者中，非穿透性PPP 52例，穿透性PPP18例。MRI联合彩色超声检测技术诊断准确性高于单项检测，但经比较数据差异无统计学意义（P＞0.05）；与非穿透性PPP比较，穿透性PPP孕产妇子宫切除率较高，新生儿重度窒息较多（P＜0.05）；与预后良好组比较，预后不良组剖宫产次数较多，分娩周期较短，手术时间较长，术中出血量较多，MRI、彩色超声评分较高（P＜0.05）；术中出血量、MRI评分、彩色超声评分是穿透性PPP孕产妇预后不良的独立危险因素（P＜0.05）；术中出血量、MRI评分、彩色超声评分AUC分别为0.806、0.854、0.806，与联合检测AUC比较，差异有统计学意义（P＜0.05）。
结论 MRI、彩色超声检测技术对穿透性PPP的诊断价值较高，对孕产妇和新生儿的预后有一定预测价值。


关键词: 前置胎盘, 磁共振成像, 超声检查, 多普勒, 彩色

Abstract: Objective To investigate the imaging features and predictive value of penetrating and pernicious placenta previa (PPP) based on magnetic resonance imaging (MRI) and color Doppler ultrasonography (CDUS). 
Methods In total, 70 pregnant and parturient women with PPP who were admitted to our hospital were selected as the research subjects, and all of them underwent MRI and CDUS examination. The diagnostic value of MRI and CDUS alone and in combination for PPP was analyzed.The characteristics of MRI and CDUS in non-penetrating PPP and penetrating PPP in pregnant and parturient women were compared, and the prognostic factors of penetrating PPP in pregnant and parturient women were analyzed.Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of MRI and CDUS scores for the prognosis of pregnant and parturient women with penetrating PPP. 
Results Among the 70 PPP patients, 52 had non-penetrating PPP and 18 had penetrating PPP. The diagnostic accuracy of MRI combined with CDUS was higher than that of single detection, but data comparison showed no statistical significance (P＞0.05). Compared with pregnant and parturient women with non-penetrating PPP, those with penetrating PPP had higher hysterectomy rate and more severe asphyxia in neonates (P＜0.05). Compared with the good prognosis group, the poor prognosis group had more cesarean sections, shorter delivery cycle, longer duration of operation, more intraoperative blood loss, and higher MRI and color Doppler scores (P＜0.05). Intraoperative blood loss, MRI score, and CDUS score were independent risk factors for poor prognosis of pregnant women with penetrating PPP (P＜0.05).The area under the ROC curve (AUC)of intraoperative bleeding, MRI score, and CDUS score were 0.806, 0.854, and 0.806, respectively, and the differences were statistically significant when compared with the AUC of combined detection (P＜0.05). 
Conclusion MRI and CDUS have high diagnostic value for penetrating PPP, and have certain predictive value for the prognosis of pregnant and parturient women and neonates. 


Key words: placenta previa, magnetic resonance imaging,  , ultrasonography, Doppler, color

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