The Applied Research Of Magnetic Resonance Imaging Examination For The Implantable Dangerous Placenta Previa During The Late Pregnancy

Objective:By studying the clinical application of the magnetic resonance imaging(MRI)forthe late pregnancy implantable dangerous placenta previa in the diagnosis and treatment,to discuss the guiding significance of it for the implantable dangerous placenta previa of the diagnosis and treatment.Methods:This study retrospectively analyzes 194 medical records,which had a caesarean section,and had been diagnosed for the implantable dangerous placenta previaby surgeryor pathologyin the affiliated hospital of Qingdao university,since January 1,2014 to February 28,2018.And then,there were 54 cases with ultrasonography(US)data and140 cases with MRI and US data.SPSS 17.0 software was used for statistical analysis of the data.The normal distributionof measurement data was expressed as((?)±S),and the difference test was conducted by t test.The statistical data were expressed by the rate,and the difference test was performed by c2 test or Fisher’s exact probability method.When the test level was<0.05,the difference was statistically significant.The consistency test was performed by Kappa test,and the Kappa coefficient was applied to test the consistency of the two evaluation results.The Kappa coefficientwas ≤0.50,indicating that the anastomosities were weak,and the Kappacoefficient was>0.50,indicating that the anastomosities were strong.The study was divided into two parts,the first part:according to the diagnostic and hierarchical diagnostic criteria of MRI,US,operation or pathology,to have a diagnosis and classification diagnosis for the 140 cases which have MRI and US data,first of all,comparing the difference of the diagnosis and classification diagnosis of the MRI and US in the implantable dangerous placenta previa;secondly,the differences and consistency between MRI,US and surgery or pathology in the classification diagnosis of the implantable dangerous placenta previa were compared;finally,the sensitivity,specificity,missed diagnosis rate and misdiagnosis rate of MRI and US in the diagnosis of various levels of the implantable dangerous placenta previa were compared.The second part,according to the operation or pathology classification diagnosis standard,all included in the study of 194 cases was divided into I,II,III type of the implantable dangerous placenta previa,and the cases which base on the results of MRI for preoperative evaluation criteria was named MRI group,then the cases which base on the results of US for preoperative evaluation criteria was named US groups,comparing the bleeding and hysterectomy rate of various type of the implantable dangerous placenta previa in the MRI and US groups.Results:1 There was no statistically significant difference between MRI and US in the diagnosis of the implantable dangerous placenta previa(c2=0.00,P>0.05).2 The difference between MRI and US in the classificationdiagnosis of the implantable dangerous placenta previa was statistically significant(c2=14.43,P<0.05).3 There was no statistically significant difference between MRI and surgeryor pathology forthe classificationdiagnosis of the implantable dangerous placenta previa(c2=6.04,P>0.05),and the anastomosis was strong(Kappa =0.55,P<0.001).4 The difference of US and surgeryor pathologyin the classificationdiagnosis of the implantable dangerous placenta previa was statistically significant(c2=8.06,P<0.05),and the anastomosis was weak(Kappa=0.31,P<0.001).5 MRI has a high sensitivity,specificity,low diagnosis rate,low misdiagnosis rate,and is more consistent with surgery or pathological diagnosis.6 At all levels,the amount of blood loss in the MRI group was less than that in the US group,and the differences between the two groups were statistically significant(P<0.05).7 here was no statistically significant difference between the MRI group and the US group in the invasive placenta preplacenta(P<0.05).Conclusions:1 MRI and US showed no difference in the diagnosis of implantable dangerous placenta previa with high detection rate.2 MRI and US are different in the classification diagnosis of implantable dangerous placenta previa.3 MRI has a higher degree of anastomosis than the US in the classificationdiagnosis of the implantable dangerous placenta previawiththe surgeryor pathology,and its application value is superior to that of US.4 Implantation at all levels in the implantable dangerous placenta previa,bleeding amount of MRI group less than US,basing on MRI diagnosis,can optimize the operation scheme,thus reducing the intraoperative bleeding,has higher guidance meaningfor the surgery of the implantable dangerous placenta previa.