بررسی دقت MRI و سونوگرافی در تشخیص پلاسنتا آکرتا در زنان مستعد مراجعه کننده به بیمارستانهای زنان سطح شهر تبریز

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

2 متخصص زنان و زایمان، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

10.22038/ijogi.2020.16282

چکیده

مقدمه: پلاسنتا آکرتا عوارض بسیار خطرناکی برای مادر و نوزاد به همراه دارد. تشخیص به‌موقع این عارضه می­تواند خطرات تهدید‌کننده سلامت مادر و نوزاد را کاهش دهد. با توجه به عدم استفاده از MRI در تشخیص به‌موقع پلاسنتا آکرتا در ایران، مطالعه حاضر با هدف بررسی دقت MRI و سونوگرافی در تشخیص پلاسنتا آکرتا در زنان مستعد مراجعه کننده به بیمارستان­های زنان سطح شهر تبریز انجام شد.
روش‌کار: این مطالعه توصیفی مقطعی در طی سال­های 95-1394 در بیمارستان­های زنان شهر تبریز با مشارکت 38 زن مستعد پلاسنتا آکرتا انجام شد. بیماران پس از معاینه به مرکز تصویربرداری (سونوگرافی و MRI) ارجاع شدند و نتایج تصویربرداری با نتایج پس از سزارین مطابقت داده شدند. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 20) و آزمون آماری مک نمار انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته‌ها: در بررسی­های انجام شده توسط MRI تعداد 17 نفر (47/89%) پلاسنتا آکرتا داشتند، در حالی که بر اساس بررسی نتایج سونوگرافی، تعداد 12 نفر (15/63%) پلاسنتا آکرتا داشتند. مقایسه اختصاصیت و حساسیت نشان داد که حساسیت (70%) و اختصاصیت (93%) سونوگرافی به‌طور معناداری نسبت به حساسیت (79%) (048/0=p) و اختصاصیت MRI (100%) (039/0=p) کمتر است.
نتیجه‌گیری: دقت، حساسیت و قدرت پیش‌بینی استفاده از تکنیک MRI در تشخیص به‌موقع این عارضه خطرناک در مقایسه با سونوگرافی بسیار مناسب بوده و می­تواند در زنان مستعد پلاسنتا آکرتا به‌کار برده شود.

کلیدواژه‌ها


عنوان مقاله [English]

Accuracy of MRI and Ultrasound in the diagnosis of placenta accreta in susceptible women referred to Tabriz gynecology hospitals

نویسندگان [English]

  • Fatemeh Abasalizadeh 1
  • Shamsi Abasalizadeh 1
  • Ladan Kalafi 2
1 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Gynecologist, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: Placenta accreta has very dangerous effects for mother and baby; timely diagnosis of this complication can decrease the maternal and neonatal health. Due to the lack of MRI use for timely diagnosis of placenta accreta in Iran, this study was performed with aim to evaluate the accuracy of MRI and ultrasound in the diagnosis of placenta accreta in susceptible women referred to gynecology hospitals in Tabriz.
Methods: This cross-sectional descriptive study was conducted in Tabriz gynecology hospitals during 2015-2016 with the participation of 38 susceptible women to placenta accreta. After examination, the patients were referred to the imaging center (ultrasound and MRI) and the results of imaging were compared with the results of after cesarean. Data were analyzed using SPSS software (version 20) and McNemar test. P< 0.05 was considered statistically significant.
Results: MRI examinations showed that 17 patients (89.47%) had placenta accreta, while ultrasound examination showed that 12 (63.15%) had placenta accreta. Comparison of the specificity and sensitivity showed that Ultrasound sensitivity (70%) and specificity (93%) were significantly lower than MRI sensitivity (79%) (p=0.048) and specificity (100%) (p=0.039).
Conclusion: The accuracy, sensitivity, and predictive power of MRI technique in timely detection of this dangerous complication were very good compared to ultrasound and can be used in women susceptible to placenta accreta.

کلیدواژه‌ها [English]

  • Diagnosis
  • MRI
  • Placenta Accreta
  • Prediction
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