| 钱晓婷,包凌云,黄安茜,单嫣娜.产前超声与磁共振检查在诊断胎盘植入中的应用[J].浙江中西医结合杂志,2019,29(3): |
| 产前超声与磁共振检查在诊断胎盘植入中的应用 |
| The Value of Prenatal Ultrasonography and Magnetic Resonance Imaging in The Diagnosis of Placenta Increta |
| 投稿时间：2018-11-21 修订日期：2018-12-07 |
| DOI： |
| 中文关键词: 胎盘植入 产前超声 磁共振 |
| 英文关键词:Placenta implantation prenatal ultrasonography magnetic resonance imaging |
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| 中文摘要: |
| 目的：探讨产前超声与磁共振检查在诊断胎盘植入中的价值。方法：回顾性分析2013年1月至2017年12月浙江省杭州市第一人民医院临床怀疑胎盘植入的病例57例，均进行产前超声及磁共振检查，与手术及病理结果相比较，分析两者在诊断胎盘植入中的敏感性、特异性、诊断符合率及Kappa值。并比较两者对不同部位的胎盘植入的诊断符合率。结果：57例分为非胎盘植入组及胎盘植入组，分别为21及36例，产前超声与磁共振诊断胎盘植入分别为40例和37例，诊断符合率86.0% vs 84.2%，差异无统计学意义（P>0.05），两者的Kappa值为0.845，一致性良好。产前超声诊断胎盘植入的敏感性高于磁共振（94.4% vs 88.9%）（P < 0.05），特异性不及磁共振（71.4% vs 76.2%）（P < 0.05）。前壁胎盘植入的诊断符合率（100.0% vs 100.0%），两者差异无统计学意义（P>0.05），非前壁胎盘植入则是磁共振诊断高于产前超声（87.5% vs 75%）（P < 0.05）。结论：产前超声与磁共振对胎盘植入有较高的诊断价值，且具有良好的一致性。超声检查因其操作简单、价格低廉且具有无创性，可作为诊断胎盘植入的首选方法。对于非前壁胎盘，可结合磁共振检查，提高胎盘植入的检出率。 |
| 英文摘要: |
| Objective The purpose of this study is to discuss the value of prenatal ultrasonography and magnetic resonance imaging in the diagnosis of placenta implantation. Material and methods A retrospective analysis of 57 cases of suspecting placenta implantation in clinical from January 2013 to December 2018 in the First People’s Hospital of Hangzhou was included in this work. They all performed prenatal ultrasonography and magnetic resonance imaging. Clinical and pathological diagnosis were recorded, the sensitivity, specificity, accuracy and Kappa between ultrasonography and magnetic resonance imaging in the diagnosis of placenta implantation were analyzed.comparing accuracy of different part of placenta implantation Results A total of 57 patients were included and divided into non-placenta and placenta implant groups. There were 40 and 37 diagnosed by prenatal ultrasonography and magnetic resonance imaging, respectively, with a diagnosis accuracy of 86.0% vs 84.2%. Though there was no significant difference, the Kappa between prenatal ultrasonography and magnetic resonance imaging was 0.845, indicating a good consistency. The sensitivity of prenatal ultrasonography is higher than magnetic resonance imaging（94.4% vs 88.9%）（P < 0.05）, nevertheless specificity is lower（71.4% vs 76.2%）（P < 0.05）. The accuracy of antetheca placenta implantation （100.0% vs 100.0%）,is no significant difference,while the accuracy of magnetic resonance imaging is higher than prenatal ultrasonography in non-antetheca placenta implantation（87.5% vs 75%） Conclusions Both of prenatal ultrasonography and magnetic resonance imaging have high diagnostic value of placenta implantation. Ultrasonography is the first choice of diagnosing placenta implantation as its simple operaration,low price and noninvasion.It’s better to combine magnetic resonance imaging in non-antetheca placenta implantation to improve detection rate. |
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