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目的探讨MRI对凶险性前置胎盘(PPP)与非凶险性前置胎盘(n PPP)及并发胎盘植入的诊断价值。方法搜集75例行MRI检查并经手术病理诊断为前置胎盘患者,绘制MRI诊断PPP及n PPP(1组)、PPP并胎盘植入(2组)以及n PPP并胎盘植入(3组)的ROC曲线,获得2、3组检查方法的敏感度、特异度及Youden指数。应用确切概率法分析比较PPP与n PPP发生胎盘植入的差异。结果 MRI诊断1组、2组、3组的ROC曲线下面积分别为0.859、0.817、0.509;MRI诊断PPP和n PPP发生胎盘植入的灵敏度、特异度、Youden指数、阳性及阴性预测值分别为77.8%、20.0%,85.7%、81.8%,0.635、0.018,96.6%、50.0%,42.9%、52.9%;比较PPP与n PPP发生胎盘植入差异具有统计学意义P(i)=17.237,P=0.000,<0.05。结论 MRI在诊断PPP与n PPP、PPP并胎盘植入方面具有较好的诊断效能。PPP合并胎盘植入的发生率高于n PPP。
Objective To investigate the diagnostic value of MRI in nosocomial placenta accreta (PPP) and nppositive placenta accreta (np). Methods 75 patients with placenta previa diagnosed by MRI and pathology were enrolled in this study. MRI and MRI were used to diagnose PPP and n PPP (group 1), PPP and placenta accreta (group 2) and n PPP with placenta accreta (group 3) The ROC curves obtained the sensitivity, specificity and Youden index of the two groups of examination methods. The exact probability method was used to analyze the difference of placenta accreta between PPP and n PPP. Results The areas under ROC curve of MRI diagnosis group 1, group 2 and group 3 were 0.859,0.817,0.509 respectively. The sensitivity, specificity, Youden index and positive and negative predictive value of MRI in diagnosis of placenta accreta in PPP and n PPP were 77.8%, 20.0%, 85.7%, 81.8%, 0.635,0.018, 96.6%, 50.0%, 42.9%, 52.9%, respectively. There was significant difference in placenta accreta between PPP and n PPP (P (i) = 17.237, P = 0.000, <0.05. Conclusion MRI has good diagnostic efficacy in diagnosis of PPP, PPP, PPP and placenta accreta. The incidence of PPP combined with placenta accreta is higher than n PPP.