天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (1): 108-112.doi: 10.11958/20180902

• 综述 • 上一篇    

孕中晚期胎盘植入的磁共振成像研究进展

张湛 1，康立清 2△   

  1. 作者单位：1天津市中心妇产科医院放射科（邮编300100）；2河北省沧州市中心医院医学影像中心 作者简介：张湛（1978），女，博士在读，主治医师，主要从事妇产科影像研究 △审校者及通讯作者 E-mail: 1513203473@qq.com
  • 收稿日期:2018-06-09 修回日期:2018-10-24 出版日期:2019-01-15 发布日期:2019-01-15
  • 通讯作者: 张湛 E-mail:zz07828@163.com

The Progress of MRI in the diagnosis of placenta accreta in the middle and third trimester of pregnancy

ZHANG Zhan1, KANG Li-qing2△   

  1. 1 Department of Radiology, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin 300100, China 2 Medical Imaging Department, Cangzhou Central Hospital, Hebei Province △Revisor and Corresponding Author E-mail: 1513203473@qq.com
  • Received:2018-06-09 Revised:2018-10-24 Published:2019-01-15 Online:2019-01-15

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摘要： 胎盘植入是产科的危重症。影像学检查是产前诊断胎盘植入的主要手段，并可对胎盘植入的治疗和预后 判断发挥指导作用。MRI在孕中晚期胎盘植入的诊断上可作为B超检查的重要补充，起到进一步明确诊断的作用。 MRI检查胎盘植入推荐在孕24~30周左右进行，胎盘植入的常见影像学改变包括以下几种：子宫与胎盘交界面肌层 变薄或T2低信号带中断、胎盘内混杂信号或T2暗带、胎盘内出血、子宫膨出、胎盘膨出、胎盘收缩、子宫颈长度缩短 等。各植入征象的诊断效能有待进一步研究。胎盘血供紊乱在植入中的作用不容忽视。对胎盘植入深度、植入面 积及不典型部位（非剖宫产瘢痕部位）植入的诊断是研究的难点及方向。

关键词: 前置胎盘, 磁共振成像, 综述, 胎盘植入

Abstract: Placenta accreta is a critical disease in obstetrics. Prenatal diagnosis depends on imaging examination and has a positive effect on treatment and prognosis of diseases. MRI can be an important supplement for B-ultrasound examination in the diagnosis of placenta accreta in middle and late pregnancy. MRI diagnosis of placenta accreta is recommended at 24-30 W gestation. The common imaging changes include the thinning of myometrium or the interruption of T 2 low signal band at the interface between uterus and placenta, heterogeneity of placental signal intensity and T2 abnormal dark interplacental bands, placental hemorrhage, abnormal uterine bulging, placental bulging, placenta recess, shortening of the uterine cervix. The role of disorganised vasculature of placenta can not be ignored. The diagnosis of the depth of placenta accreta, the accretion area and the atypical site (non-caesarean scar) are the difficult point and direction of the study.

Key words: placenta previa, magnetic resonance imaging, review, placenta accreta