摘要:目的探讨MRI征象回归模型在植入型凶险性前置胎盘的应用价值。方法回顾性分析本院350例具有完整临床资料的凶险性前置胎盘患者的MRI资料,包含20例植入型凶险性前置胎盘和330例非植入型凶险性前置胎盘。采用Logistic回归模型评估胎盘MRI征象与植入型凶险性前置胎盘相关性。结果植入型凶险性前置胎盘的单变量分析结果提示各因素预测胎盘植入风险的能力由大到小依次为子宫局限性隆凸、胎盘内T-2WI低信号带、子宫肌层变薄或局限性中断、胎盘信号不均匀、胎盘突出征、剖宫产≥2次、宫颈缩短、胎盘下异常血管、子宫下段及宫颈血管丰富。多变量分析结果提示,子宫局限性隆凸(X1:OR=25.41,P=0.02)、剖宫产≥2次(X2:OR=9.1,P=0.02)、宫颈缩短(X3:OR=7.77,P=0.04),胎盘内T-2低信号带(X4:OR=2.87,P=0.43)4个因素与凶险性前置胎盘植入有关,为凶险性前置胎盘独立危险因素。建立评估植入型凶险性前置胎盘Logistic的回归模型,Logistic(P)=-7.61+25.41X1+9.1X2+7.77X3+2.87X4,该模型预测植入型凶险性前置胎盘的准确率为98.0%。结论 MRI征象回归模型评估植入型凶险性前置胎盘具有一定的指导意义。
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