The use of magnetic resonance imaging to predict placenta previa with placenta accreta spectrum

2020 ◽  
Vol 99 (12) ◽  
pp. 1657-1665
Author(s):  
Hiroki Ishibashi ◽  
Morikazu Miyamoto ◽  
Hiroshi Shinmoto ◽  
Shigeyoshi Soga ◽  
Hiroko Matsuura ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Resonance Imaging ◽  
Placenta Accreta Spectrum

Ultrasound and magnetic resonance imaging in the diagnosis of clinically significant placenta accreta spectrum disorders

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Cecilia Cavalli ◽  
Claudia Maggi ◽  
Sebastiana Gambarini ◽  
Anna Fichera ◽  
Amerigo Santoro ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Color Doppler ◽  
Histopathological Diagnosis ◽  
Resonance Imaging ◽  
Placenta Accreta Spectrum ◽  
Clinically Significant ◽  
Placental Lacunae

Abstract Objectives We aimed to assess the performance of ultrasound (US) and magnetic resonance imaging (MRI) signs for antenatal detection of placenta accreta spectrum (PAS) disorders in women with placenta previa (placental edge ≤2 cm from the internal uterine orifice, ≥260/7 weeks’ gestation) with and without a history of previous Caesarean section. Methods Single center prospective observational study. US suspicion of PAS was raised in the presence of obliteration of the hypoechoic space between uterus and placenta, interruption of the hyperechoic uterine-bladder interface and/or turbulent placental lacunae on color Doppler. All MRI studies were blindly evaluated by a single operator. PAS was defined as clinically significant when histopathological diagnosis was associated with at least one of: intrauterine balloon placement, compressive uterine sutures, peripartum hysterectomy, uterine or hypogastric artery ligature, uterine artery embolization. Results A total of 39 women were included: 7/39 had clinically significant PAS. There were 6/18 cases of PAS with anterior placenta: hypoechoic space interruption and placental lacunae were the most sensitive sonographic signs (83%), while abnormal hyperechoic interface was the most specific (83%). On MRI, focal myometrial interruption and T2 intraplacental dark bands showed the best sensitivity (83%), bladder tenting had the best specificity (100%). 1/21 women with posterior placenta had PAS. There was substantial agreement between US and MRI in patients with anterior placenta (κ=0.78). Conclusions US and MRI agreement in antenatal diagnosis of clinically significant PAS was maximal in high-risk women. Placental lacunae on ultrasound scan and T2 intraplacental hypointense bands on MRI should trigger the suspicion of PAS.

The Use of Magnetic Resonance Imaging to Predict Placenta Previa With Placenta Accreta Spectrum

2021 ◽  
Vol 41 (3) ◽  
pp. 137-138
Author(s):  
H. Ishibashi ◽  
M. Miyamoto ◽  
H. Shinmoto ◽  
S. Soga ◽  
H. Matsuura ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Resonance Imaging ◽  
Placenta Accreta Spectrum

Accuracy and Interobserver Reliability of Magnetic Resonance Imaging for Placenta Accreta Spectrum Disorders

2020 ◽  
Author(s):  
Brett D. Einerson ◽  
Christina E. Rodriguez ◽  
Robert M. Silver ◽  
Meghan A. Donnelly ◽  
Anne M. Kennedy ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Placenta Accreta ◽  
Interobserver Reliability ◽  
Diagnostic Testing ◽  
Kappa Statistics ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Placenta Accreta Spectrum

Abstract Objective This study aims to define the accuracy, predictive value, and interobserver reliability of magnetic resonance imaging (MRI) in the diagnosis of placenta accreta spectrum (PAS) disorders. Study Design Two experienced radiologists independently interpreted the MRI studies of patients with possible PAS from two referral centers. Radiologists were blinded to sonographic and clinical information. We calculated diagnostic testing characteristics and kappa statistics of interobserver reliability for MRI findings of PAS. Results Sixty-eight MRI cases were evaluated. Confirmed PAS and severe PAS were present in 44 (65%) and 20 (29%) cases. For the diagnosis of any PAS, MRI had a sensitivity 66%, specificity 71%, positive predictive value (PPV) 81%, negative predictive value (NPV) 53%, and accuracy 68%. For the diagnosis of severe PAS (percreta), MRI had a sensitivity 85%, specificity 79%, PPV 63%, NPV 93%, and accuracy 81%. The accuracy of individual signs of PAS was lower (44–65%). Interobserver agreement was almost perfect for previa; substantial for myometrial interruptions, PAS, severe PAS, and placental bulging/balling; and moderate to slight for other signs of PAS. Conclusion Although the interobserver reliability of MRI for a diagnosis of PAS is substantial, the accuracy and predictive value are modest and lower than previously reported.

scholarly journals Assessment of Sensitivity and Specificity of Ultrasound and Magnetic Resonance Imaging in the Diagnosis of Placenta Accreta

2018 ◽  
Vol 41 (01) ◽  
pp. 017-023 ◽  
Author(s):  
Elisa Lopes ◽  
Francisco Feitosa ◽  
Antonio Brazil ◽  
José de Castro ◽  
Jesus da Costa ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Resonance Imaging ◽  
Chi Squared ◽  
History Of ◽  
The Mean

Objective To assess and compare the sensitivity and specificity of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta in patients with placenta previa. Methods This retrospective cohort study included 37 women, and was conducted between January 2013 and October 2015; 16 out of the 37 women suffered from placenta accreta. Histopathology was considered the gold standard for the diagnosis of placenta accreta; in its absence, a description of the intraoperative findings was used. The associations among the variables were investigated using the Pearson chi-squared test and the Mann-Whitney U-test. Results The mean age of the patients was 31.8 ± 7.3 years, the mean number of pregnancies was 2.8 ± 1.1, the mean number of births was 1.4 ± 0.7, and the mean number of previous cesarean sections was 1.2 ± 0.8. Patients with placenta accreta had a higher frequency of history of cesarean section than those without it (63.6% versus 36.4% respectively; p < 0.001). The mean gestational age at birth among women diagnosed with placenta previa accreta was 35.4 ± 1.1 weeks. The mean birth weight was 2,635.9 ± 374.1 g. The sensitivity of the ultrasound was 87.5%, with a positive predictive value (PPV) of 65.1%, and a negative predictive value (NPV) of 75.0%. The sensitivity of the magnetic resonance imaging was 92.9%, with a PPV of 76.5%, and a NPV of 75.0%. The kappa coefficient of agreement between the 2 tests was 0.69 (95% confidence interval [95%CI]: (0.26–1.00). Conclusion The ultrasound and the magnetic resonance imaging showed similar sensitivity and specificity for the diagnosis of placenta accreta.

Role of Magnetic Resonance Imaging in the Antenatal Diagnosis of Placenta Accreta - A Case Report

2020 ◽  
pp. 26-29
Author(s):  
OJS Admin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Placenta Accreta ◽  
Antenatal Diagnosis ◽  
Placenta Previa ◽  
Color Doppler ◽  
Myometrial Invasion ◽  
Resonance Imaging ◽  
Gadolinium Contrast ◽  
Chorionic Villi

Placenta Previa (PP) is the abnormal presence of placenta in front of internal os and can be classified into three types (Marginal, partial and complete PP. Transabdominal ultrasound is an effective modality toevaluate PP. Placenta Accreta (PA) occurs when chorionic villi insert deep into the myometrium due to imperfection of decidua basalis. PAis classified on the basis of myometrial invasion. The mildest form of PAis placenta accreta Vera which is classified as attachment of chorionic villi to the myometrium but sparing the muscle. There are 10% chances of PA in women with the initial diagnosis of PP. Previous cesarean section and advanced maternal age are independent risk factors for this high-risk group. Undiagnosed PP is related to significant maternal mortality (up to 25%) and morbidity which occurs due to intrapartum hemorrhage, uterine rupture, abscess formation, and bladder and rectum invasion. The reliability of Brightness mode and color Doppler ultrasound varies widely in different studies for antenatal diagnosis of PA. Magnetic resonance imaging, with and without gadolinium contrast, has been scrutinized as the modality for the greater precision of the antenatal diagnosis of PA in recent times.

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