The Value Of Prenatal Ultrasound Combined With MRI In Diagnosis Of Placenta Accreta

In recent years,the incidence of placenta increta(PIA)in pregnant women has also increased year by year with the increase in cesarean section,more prolific history,older mothers and abortions.According to relevant literature,the current incidence of PIA is about 0.3% to 0.6%.When high-risk factors are combined,the incidence of PIA is as high as 34%.As a serious complication that affects maternal and fetal life,PIA can cause major bleeding in pregnant women.,uterine perforation,infection,disseminated intravascular coagulation(DIC)or even death,therefore,if the prenatal diagnosis of PIA can be correctly improved,the prenatal diagnosis rate of PIA is improved,and the correct diagnosis and treatment plan for the clinic is established.Reducing maternal postpartum mortality will play a very important role.Color Doppler Flow Imaging(CDFI)Ultrasonography(US)mainly includes two-dimensional(2D)and three-dimensional(3D)imaging technologies.2D imaging technology prenatal examination of pregnant women with suspected PIA,can show the relationship between the post-placental space and the bladder wall,at the same time has the advantages of non-invasive,easy to operate,low cost,long data storage time and other inspection methods do not have the advantages,but at the same time There are some disadvantages,such as the inability to display the blood flow behind the placenta,and at the same time,the operator's skill is required.3D imaging technology can clearly show the post-placental blood flow,but when the placenta is attached to the posterior wall of the uterus,the US examination is difficult to show the posterior placental space,and affected by the fetus and its appendages,the reliability of the diagnosis will be significantly reduced.Magnetic resonance imaging(MRI)examination has higher resolution in soft tissue,and has multi-faceted,multi-azimuth,multi-parametric imaging characteristics,and is less affected by intestinal gas,abdominal wall thickness,can be more clear The relationship between the myometrium and the placenta is shown,but the instrument is more complex and the price is more expensive,further limiting its widespread use.The combination of US and MRI,combined with mutual imaging features,will help increase the prenatal diagnosis rate of PIA,and avoid the occurrence of severe complications such as postpartum uterine rupture and hemorrhage.Purpose:This study investigated the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic coincidence rate of US with MRI compared with US and MRI in the diagnosis of PIA.At the same time,we compared the typical imaging features of PIA with the US and MRI.Diagnostic significance and clinical value of PIA.Method:A US Ge Voluson E8 color Doppler diagnostic instrument and a US GE HDxt 1.5T superconducting magnetic resonance diagnostic instrument were used to perform US and MRI examinations on 105 patients with suspected PIA,and statistically analyze US examinations,MRI examinations,and US integration.MRI was used to diagnose PIA sensitivity,specificity,positive predictive value,negative predictive value and diagnostic coincidence rate.At the same time,the typical imaging features of PIA were recorded.The diagnostic value and important clinical significance of US-associated MRI for PIA were compared and analyzed.Result:1.US-combined MRI examination was more consistent with the "gold standard" than US and MRI(Kappa=0.884,Kappa=0.591,Kappa=0.532).2.Compared with US and MRI examinations,the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of US-associated MRI examination for PIA diagnosis were high,with significant differences(P<0.05)..3.47 PIA patients diagnosed with US,combined with MRI showed typical imaging features of PIA such as disappearance of posterior placenta,formation of placental eddies,increased postplacental vascularity,and thinning of myometrium after placenta.Compared with US examination and MRI Check(P<0.05).In conclusion:US examination is one of the most commonly used imaging methods for prenatal diagnosis of PIA.However,when there is more intestinal gas and a thicker abdominal wall,the diagnostic performance will be significantly reduced.MRI examination will make up for this shortcoming.US combined with MRI examination compared with US examination and MRI examination has higher sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic coincidence rate for diagnosis of PIA,and it can well display typical imaging features of PIA such as placenta.After the disappearance of the gap,the formation of placental eddies,after the placenta is rich in blood vessels and thinning of the myometrium after the placenta.