Diagnostic value of MRI for postpartum placenta implantation

doi:10.16150/j.1671-2870.2017.05.014

Abstract

Abstract: Objective: To investigate the imaging characteristics and diagnostic value of magnetic resonance imaging (MRI) for postpartum placenta implantation. Methods: Fifty-two patients with suspicious postpartum placenta implantation receiving MRI examination were enrolled. The imaging findings on MRI were analyzed in correlation with the clinical and pathological data, and diagnostic performance was calculated. Results: Of the 53 cases, 35 cases were diagnosed as placenta implantation by surgery or pathologic examination, and of them 31 were diagnosed by MRI, with a sensitivity of 88.57%, and specificity of 88.24%. The main MRI feature was placenta-myometrium interface disappearance with a diagnostic sensitivity of 91.43%. And secondly, myometrium was thinned and placenta signal was uneven(sensitivity 74.29% and 68.57%). The sensitivity and specificity of enhanced MRI examination for diagnosing postpartum placenta implantation were 54.29% and 100% respectively. Four cases of retained placenta diagnosed by preoperative MRI were confirmed to be placenta implantation by pathological examination after surgery, While 2 cases of retained placenta were misdiagnosed as placenta implantation by preoperative MRI. Conclusions: MRI is valuable for diagnosing postpartum placenta implantation. For patients with postpartum recovery time less than 4 weeks, enhanced MRI scan is recommended.

Key words: Postpartum, Placenta implantation, Magnetic resonance imaging

CLC Number:

R445.2

SU Ming, ZHANG Jijun, LING Huawei, ZHANG Jian, DING Bei, LU Fei, LIU Yan. Diagnostic value of MRI for postpartum placenta implantation[J]. Journal of Diagnostics Concepts & Practice, 2017, 16(05): 527-531.

References

[1] Sinha P, Mishra M.Caesarean scar pregnancy: a precursor of placenta percreta/accreta[J]. J Obstet Gynaecol,2012,32(7):621-623.
[2] Baughman WC, Corteville JE, Shah RR.Placenta accreta: spectrum of US and MR imaging findings[J]. Radiographics,2008,28(7):1905-1916.
[3] Wu S, Kocherginsky M, Hibbard JU.Abnormal placentation: twenty-year analysis[J]. Am J Obstet Gynecol,2005, 192(5):1458-1461.
[4] El Behery MM, Rasha LE, El Alfy Y. Cell-free placental mRNA in maternal plasma to predict placental invasion in patients with placenta accreta[J]. Int J Gynaecol Obstet,2010 Apr,109(1):30-33.
[5] 朱铭. 胎儿磁共振——磁共振检查的新领域[J]. 磁共振成像,2011,2(1):7-12.
[6] 刘炳光, 曹满瑞, 张方璟, 等. 比较快速自旋回波序列和平衡式快速场回波序列对胎盘植入征象的显示效能[J]. 中国医学影像技术,2013,29(2):302-305.
[7] Lim PS, Greenberg M, Edelson MI, et al.Utility of ultrasound and MRI in prenatal diagnosis of placenta accreta: a pilot study[J]. Am J Roentgenol,2011,197(6):1506-1513.
[8] 丁立, 康敏, 宋筱, 等. MRI扩散加权成像诊断妊娠胎盘植入的应用价值[J]. 华西医学,2015,30(5):915-918.
[9] Manganaro L, Fierro F, Tomei A, et al.MRI and DWI: feasibility of DWI and ADC maps in the evaluation of placental changes during gestation[J]. Prenat Diagn,2010, 30(12-13):1178-1184.
[10] 刘湘萍, 王竞, 杨晓文, 等. 凶险型前置胎盘产前彩超和MRI诊断价值比较[J]. 中国医药科学,2013,3(22):10-11.
[11] 梁娜, 田伟. MRI在胎盘植入中的研究进展[J]. 实用放射学杂志,2013,23(1):315-318.
[12] 鲍芳, 郑穗生, 王龙胜, 等. 胎盘植入的MRI征象及其诊断价值[J]. 安徽医学,2016,37(5):533-535.
[13] 邹爱国, 王毅, 方必东, 等. 胎盘植入的MRI诊断价值[J]. 医学影像学杂志,2009,19(10):1312-1314.
[14] 程敏. MRI对胎盘植入的诊断价值[J]. 中国妇产科临床杂志,2010,11(4):312-314.
[15] 彭软, 谢红宁, 杨建波, 等. 胎盘植入的产前超声诊断及其影响因素研究[J]. 中国临床医学影像杂志,2010, 21(1):67-69.