Diagnostic accuracy of magnetic resonance imaging in assessing placental adhesion disorder in patients with placenta previa: Correlation with histological findings

Autor: Mario Petretta, G. Frauenfelder, Arturo Brunetti, P.P. Mainenti, Simone Maurea, M. I. Ginocchio, Maddalena Morlando, Valeria Romeo, Raffaele Liuzzi, Francesco Verde, Maria D'Armiento, Laura Sarno, Pasquale Martinelli
Přispěvatelé: Maurea, S., Romeo, V., Mainenti, P. P., Ginocchio, M. I., Frauenfelder, G., Verde, Francesco, Liuzzi, R., D'Armiento, M., Sarno, L., Morlando, M., Petretta, M., Martinelli, P., Brunetti, A., Verde, F., Liuzzi, Rosa, Morlando, Maddalena
Rok vydání: 2018
Předmět:
Prenatal Diagnosi
Adult
Radiology
Nuclear Medicine and Imaging
Placenta
Placenta Previa
Reproducibility of Result
Adhesion (medicine)
Placenta Accreta
Focal interruption of myometrial border
030218 nuclear medicine & medical imaging
Correlation
03 medical and health sciences
Young Adult
0302 clinical medicine
Vascularity
Pregnancy
Prenatal Diagnosis
Medicine
Humans
In patient
Magnetic resonance imaging (MRI)
Prospective Studies
030219 obstetrics & reproductive medicine
medicine.diagnostic_test
Receiver operating characteristic
business.industry
Ultrasound
Reproducibility of Results
Magnetic resonance imaging
General Medicine
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Placenta previa
Prospective Studie
Myometrium
Intraplacental dark band
Female
medicine.symptom
business
Nuclear medicine
Human
Placental adhesion disorder (PAD)
Zdroj: European journal of radiology. 106
ISSN: 1872-7727
Popis: Objective: To evaluate MRI accuracy in assessing placental adhesion disorders (PAD) in patients with placenta previa correlating imaging results with histological findings. Materials and methods: Sixty-one patients who underwent abdomino-pelvic magnetic resonance imaging (MRI) for ultrasound suspicion of PAD were prospectively evaluated. T1- and T2-weighted images, with and without fat suppression, were obtained in the three conventional planes using a 1.5 T MRI scanner. MRI accuracy to evaluate the presence of PAD was assessed on the basis of the occurrence of the following abnormal MRI signs: 1) intraplacental dark bands; 2) focal interruption of myometrial border; 3) intraplacental abnormal vascularity; 4) uterine bulging; 5) tenting of the bladder and/or 6) direct visualization of adjacent tissues invasion only in case of percretism. Imaging results were classified as suggestive or not of PAD using histological data as standard of reference; two methods of imaging analysis were used represented by the presence of at least one (Method A) or two (Method B) abnormal MRI signs; the correlation between the presence of each abnormal MRI sign of PAD and the corresponding histological finding was also assessed. Results: The accuracy, as the area under the receiver operating characteristic curve, was significantly (p = 0.001) higher for Method B (0.92, C.I. 95%: 0.82–0.97) compared to Method A (0.764, C.I. 95%: 0.64–0.86). Among the abnormal MRI signs, intraplacental dark bands and focal interruption of myometrial border were those highly correlated with histological proof of PAD (ρ > 0.71, p < 0.001, for both); as result, a modified version of Method B (Method C) was identified considering as criterion for PAD the combined presence of the two abnormal MRI signs highly correlated with histologically proven PAD; however, the accuracy of Method C was significantly (p = 0.005) lower (0.80, C.I. 95%: 0.67–0.89) than Method B and comparable to Method A. Conclusions: MRI is a useful imaging technique to assess PAD in patients with placenta previa; in particular, the presence of at least two among all the abnormal MRI signs represents the most accurate criterion (Method B) to identify PAD. Although intraplacental dark bands and focal interruption of myometrial border showed the highest correlation with histological proof of PAD as well as this association was the most frequent in PAD, the combination of these latter MRI signs along with other abnormal signs should be considered diagnostic for PAD.
Databáze: OpenAIRE
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