The Value of MRI Image Combined with Ultrasound Image Features in the Diagnosis and Prediction of Adverse Clinical Outcomes of Invasive Placental Implantation
Objective To explore the diagnostic value of magnetic resonance imaging(MRI)imaging combined with ultrasound image characteristics for invasive placental implantation,and analyze its predictive value for adverse clinical outcomes.Methods A total of 156 pregnant women with suspected placenta implantation admitted to our hospital from August 2021 to February 2023 were selected for ultrasound and MRI examinations,classification of placental implantation based on surgical or pathological results as the"gold standard",and the patients were divided into invasive group(implantation type,penetrating type)and non-invasive group(non-placenta implantation,adhesive placenta).The characteristics of MRI and ultrasound images were compared between the two groups,and multivariate Logistic regression analysis was performed to analyze the diagnostic value of MRI and ultrasound image characteristics for invasive placenta accreta.Based on the clinical outcomes of pregnant women with invasive placenta implantation,they were divided into adverse outcome group and good outcome group.The MRI and ultrasound image characteristics of pregnant women with different outcomes were compared,and the predictive value of MRI and ultrasound characteristics for adverse outcomes was analyzed.Results Based on surgical and pathological diagnosis,156 pregnant women with suspected placenta implantation were divided into an invasive group(94 cases)and a non-invasive group(62 cases).Multivariate Logistic regression analysis showed that the thinning of the myometrium,low signal intensity on T2WI in the placenta,unclear boundary between the myometrium and placenta,abnormal hyperplastic blood vessels in the placenta,localized bulging of the placenta/uterus,disappearance of the posterior interstitial space of the placenta,worm-like changes in the placenta,blood flow disorder in the basal part of the placenta,and ultrasound signs such as score of MRI imaging and ultrasound image characteristics were all factors affecting invasive placental implantation(P＜0.05).The comparison of the above MRI imaging and ultrasound image characteristics between the poor outcome group and the good outcome group showed statistically significant differences(P＜0.05).The AUC of the combined diagnosis of invasive placental implantation by MRI images and ultrasound images was 0.928,and the AUC of the combined prediction of adverse outcomes of invasive placental implantation was 0.936(P＜0.05).Conclusion MRI imaging and ultrasound image characteristics can be used for the diagnosis of invasive placental implantation.The combination of uterine muscle thinning,low T2WI signal in the placenta,unclear uterine muscle-placenta boundary,abnormal vascular proliferation in the placenta,localized bulging of the placenta/uterus,disappearance of the posterior placental space,worm-like changes in the placenta,blood flow disorder in the placental basal part,and ultrasound signs score diagnosis has higher diagnostic efficiency,and the combined prediction of adverse outcomes of invasive placental implantation is of high value.
万方数据
维普
