快速平衡稳态采集和单次激发快速自旋回波序列产前诊断胎盘植入的价值比较

doi:10.3881/j.issn.1000-503X.10486

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2019, Vol. 41 ›› Issue (1): 86-92.doi: 10.3881/j.issn.1000-503X.10486

• Original Articles • Previous Articles Next Articles

Comparison of Prenatal Diagnostic Value between Fast Imaging Employing Steady State Acquisition and Single Shot Fast Spin Echo Sequence in Diagnosis of Placental Invasion

MA Hongli,Lü Furong(),XIAO Zhibo,DU Jinchao,SHENG Bo

Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China

Received:2018-04-20 Online:2019-02-28 Published:2019-03-06
Contact: Furong Lü E-mail:lfr918@sina.com
Supported by:
Supported by the National Clinical Key Subject Construction Project of China(2013-544)

Abstract

Abstract:

Objective To compare the prenatal diagnostic value and image quality of magnetic resonance imaging(MRI)with fast imaging employing steady state acquisition(FIESTA)or single shot fast spin echo(SSFSE)sequence,in order to provide references for sequence selection of prenatal diagnosis.Methods The MRI data of 121 patients with suspected placental invasion were retrospectively analyzed. The ability of FIESTA in displaying MRI signs associated with placental invasion and its image quality were assessed and compared with SSFSE. Based on the records of cesarean section and pathological finding,the sensitivity,specificity,positive predictive values,and negative predictive values of these two sequences were calculated.Results The image quality was significantly higher in FIESTA than in SSFSE(χ ²=29.74,P=0.000). FIESTA had significantly higher ability to display focal interruptions in the myometrial wall than SSFSE(χ ²=6.750,P=0.006);in addition,the ability to display abnormal vessel in the placenta(χ ²=8.471,P=0.020),placental heterogeneity(χ ²=13.885,P=0.000),hypointense intraplacental bands(χ ²=4.267,P=0.035)were also significantly higher in SSFSE than in FIESTA,while the efficiency for displaying uterine bulging(χ ²=0.250,P=0.625),uterine recess(χ ²=0.167,P=0.687),uterine penetration and parametrium implantation(χ ²=0.800,P=0.375),and protrusion of the placenta into the cervix(χ ²=0.081,P=0.776)were not significantly different between these two sequences. Both sequences had a specificity of 100% in displaying uterine penetration and parametrium implantation,uterine recess,and protrusion of the placenta into the cervix. Conclusions FIESTA has better ability in displaying the contour and demarcation of placenta and uterine,whereas SSFSE is more efficient in displaying the changes of intraplacental signals. FIESTA can be used to observe the relationship between the placenta and the surrounding structures and whether the surrounding tissue is implanted,and the changes of placental signals can be observed in SSFSE. The combination of these two sequences can improve the prenatal diagnosis of placenta invasion.

Key words: magnetic resonance imaging, placental invasion, fast imaging employing steady state acquisition, single shot fast spin echo

CLC Number:

R445

MA Hongli,Lü Furong,XIAO Zhibo,DU Jinchao,SHENG Bo. Comparison of Prenatal Diagnostic Value between Fast Imaging Employing Steady State Acquisition and Single Shot Fast Spin Echo Sequence in Diagnosis of Placental Invasion[J].Acta Academiae Medicinae Sinica, 2019, 41(1): 86-92.

Figures/Tables 6

Table 1

Fig 1

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Fig 3

Table 2

Table 3

References 18

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序列Sequence	ABV	PH	HIB	UB	FIM	UR	UPPI	PPC
FIESTA	59(52)	68(59)	56(50)	56(52)	70(62)	24(24)	13(13)	7(7)
SSFSE	72(65)	88(75)	65(57)	54(51)	60(49)	22(22)	10(10)	6(6)
χ²	8.471	13.885	4.267	0.250	6.750	0.167	0.800	0.081
P	0.020	0.000	0.035	0.625	0.006	0.687	0.375	0.776

征象Sign	敏感度 Sensitivity	特异度Specificity	PPV	NPV
ABV	67.71(65/96)	72.00(18/25)	90.28(65/72)	36.73(18/49)
PH	78.12(75/96)	48.00(12/25)	85.23(75/88)	36.36(12/33)
HIB	59.38(57/96)	68.00(17/25)	87.69(57/65)	30.36(17/56)
UB	53.13(51/96)	88.00(22/25)	94.44(51/54)	32.84(22/67)
FIM	51.04(49/96)	56.00(14/25)	81.67(49/60)	22.95(14/61)
UR	22.92(22/96)	100.00(25/25)	100.00(22/22)	25.25(25/99)
UPPI	10.41(10/96)	100.00(25/25)	100.00(10/10)	22.52(25/111)
PPC	6.25(6/96)	100.00(25/25)	100.00(6/6)	21.74(25/115)

征象 Sign	敏感度Sensitivity	特异度Specificity	PPV	NPV
ABV	54.17(52/96)	72.00(18/25)	88.14(52/59)	29.03(18/62)
PH	61.46(59/96)	64.00(16/25)	86.76(59/68)	30.19(16/53)
HIB	52.08(50/96)	76.00(19/25)	89.29(50/56)	29.23(19/65)
UB	54.16(52/96)	84.00(21/25)	92.86(52/56)	32.31(21/65)
FIM	64.58(62/96)	68.00(17/25)	88.57(62/70)	33.33(17/51)
UR	25.00(24/96)	100.00(25/25)	100.00(24/24)	25.51(25/98)
UPPI	13.54(13/96)	100.00(25/25)	100.00(13/13)	23.15(25/108)
PPC	7.29(7/96)	100.00(25/25)	100.00(7/7)	21.93(25/114)

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Comparison of Prenatal Diagnostic Value between Fast Imaging Employing Steady State Acquisition and Single Shot Fast Spin Echo Sequence in Diagnosis of Placental Invasion

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