Application Of MRI Combined With Creatine Kinase In The Diagnosis Of Dangerous Placenta Previa With Placenta Accreta

Purpose : To analyze the risk factors of PPP(Pernicious placenta previa)with placenta accreta?Methods: From January 2018 to January 2020,60 cases of PPP patients with placenta accreta confirmed by surgery pathology and also 60 cases of placentas without placenta previa were selected as the control group for statistical clinical data.Then univariate Logistic analysis was used to analyze the differences between the two groups of patients' clinical data,and multivariate Logistic analysis was performed for the indicators with statistically significant differences.Results:Age,gestational week,history of pregnancy,and fetal weight were related factors of PPP with placenta accreta(P < 0.05).Multivariate Logistic analysis showed that gestational week and history of pregnancy were the high-risk factors for PPP with placenta accreta(P < 0.05).Conclusion:There are many factors associated with the formation of PPP with placenta accreta:Age,gestational week,history of pregnancy,and fetal weight.The gestational week and history of pregnancy are high-risk factors.Attention should be paid to such pregnant women and preventive preparations should be made to ensure the safety of delivery and maternal and perinatal health.Purpose:To analyze the clinical application value of CK(creatine kinase)in MRI diagnosis of PPP with placenta accreta.Methods:(1)From January 2018 to January 2020,60 cases of suspected PPP patients with placenta accreta confirmed by surgery pathology.MRI,CK,and MRI+CK test were performed in PPP patients with placenta accreta respectively,the diagnostic coincidence rate,the specificity and sensitivity,the positive predictive value and the negative predictive value of MRI,serum CK,MRI+ serum CK combined diagnosis were compared.(2)The consistence of the serum CK content and Kappa test surgery pathology diagnosis of different PPP groups with placenta accreta with MRI were compared.Results:(1)Surgery pathology diagnosed PPP 57 cases with placenta accreta.MRI confirmed54 cases,the diagnostic coincidence rate was 93.33%,the diagnostic sensitivity was94.73%,the specificity was 66.67%,the positive predictive value was 98.18%,the negative predictive value was 40.00%.CK confirmed 24 cases,the diagnostic coincidence rate was 43.33%,the diagnostic sensitivity was 42.10%,the specificity was 66.67%,the positive predictive value was96.00%,the negative predictive value was 42.10%.MRI combined with serum CK confirmed 56 cases,the diagnostic coincidence rate was 96.67%,the diagnostic sensitivity was 98.24%,the specificity was 66.67%,the positive predictive value was 98.24%,the negative predictive value was 66.67%.MRI combined with serum CK diagnosis PPP placenta accreta improved the diagnostic coincidence rate,the diagnostic sensitivity and the positive predictive value.(2)Surgery pathology diagnosed 10 cases of marginal type,14 cases of partial type and 30 cases of complete type.MRI was used to diagnose 10 cases of marginal type,13 cases of partial type,and 31 cases of complete type.Kappa test MRI showed good consistency with surgery pathology diagnosis In in terms of consistency.Compared with partial groups,The serum CK level of the central group was significantly higher,(P=0.030).There was no significant increase in serum CK level in partial group compared with marginal group,(P= 0.372).Conclusion:(1)MRI combined with CK has a high application value in the diagnosis of PPP with placenta accreta,which can provide a scientific reference for the diagnosis and treatment of the disease.(2)The diagnostic coincidence rate between MRI and surgical pathology in the diagnosis of placenta previa classification is high,which can be used in clinical auxiliary diagnosis of placenta previa classification.