Intraplacental T2-hypointense bands may help predict placental invasion depth and postpartum hemorrhage in placenta accrete spectrum disorders in high-risk gravid patients

Hu, Yumin; Wang, Yi; Weng, Qiaoyou; Wu, Xia; Xia, Shuiwei; Wang, Hailin; Cheng, Xue; Mao, Chenchen; Li, Xia; Zhou, Zhangwei; Chen, Chunmiao; Xu, Min; Wang, Zufei; Ji, Jiansong

doi:10.1016/j.mri.2022.09.005

Cited by 5 publications

(5 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The ultrasonic sign-scoring scale used in this study complied with the previous protocol, and details of the scored components ( 1 ) can be found in Table 1 and Figure 1 .…”

Section: Methodsmentioning

confidence: 99%

“…In recent decades, the diagnosis and management of placenta accrete spectrum (PAS) has represented a great challenge to obstetricians in clinical practice ( 1 , 2 ). Due to the obscure clinical manifestations and lack of laboratory tests for PAS, there is no method currently available that allows the depth of invasion of PAS to be predicted before surgery or that can distinguish among PA, placenta increta (PI), and placenta percreta (PP) ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…Ultrasound (US) and magnetic resonance imaging (MRI) are still the most commonly used imaging techniques for the diagnosis of PA. Due to its wide application and low cost, US is one of the most used diagnostic methods for PAS ( 1 ). A model with 4 US markers could predict the possibility and severity of PAS with high accuracy ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…Some deep tissue may not show clearly, like posterior location of the placenta or obese maternal body. MRI could be applied to preoperative diagnosis and surgical planning ( 1 ). MRI can clearly show the spatial position of the placenta, and clearly show the relationship between the uterus and adjacent organs and tissues.…”

Section: Introductionmentioning

confidence: 99%

“…MRI can clearly show the spatial position of the placenta, and clearly show the relationship between the uterus and adjacent organs and tissues. An MRI based study showed intraplacental T2-hypointense bands is an efficient method to diagnose PAS ( 1 ). However, the MRI machine and exam fee are very high compared with US.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Comparisons of the diagnostic accuracy of the ultrasonic sign-score method and MRI for PA, PI and PP in high-risk gravid women: a retrospective study

Ye¹,

Li²,

Li³

et al. 2023

Ann Transl Med

View full text Add to dashboard Cite

Background The diagnosis and management of placenta accrete spectrum (PAS) is a great challenge to obstetricians. Ultrasound (US) and magnetic resonance imaging (MRI) are two main methods to detect PAS. MRI has high resolution, but the examination fee is expensive. US machine and examination fee is cheap, but the resolution is relatively low. Balancing the cost and accuracy for PAS diagnosis is very important. Methods The ultrasonic sign-score method and MRI findings for 49 pregnant women at high risk of placental implantation were retrospectively analyzed. Inclusion criteria: (I) at high risk for PA as described in the Guidelines to Placenta Accreta Spectrum Disorders issued by the American College of Obstetricians and Gynecologists (ACOG) in 2018; (II) complete records of ultrasonic sign-scoring method and MRI data; (III) cesarean section; (IV) definite surgical and/or pathological findings. The results were validated by the gold-standard surgical or postoperative pathological findings, and the efficacy of the 2 imaging approaches in diagnosing placenta PAS was compared. Kappa test was used to analyze the consistency. Receiver operating characteristic (ROC) curves were used to compare the sensitivity and specificity. Results The mean maternal age was 32.6±4.4 years. The mean gestational week was 35.9±2.0 weeks. The mean gravidity was 3.3±1.1. The surgical or histopathological findings revealed PA in 26, placenta increta (PI) in 19 and placenta percreta (PP) in 4 of the 49 women. The diagnosis accuracy of PA, PI, and PP was higher using the ultrasonic sign-scoring method than MRI (75.51%, 73.47%, and 97.96% vs. 61.22%, 57.14% and 91.84%, respectively). The areas under the ROC curve for the sensitivity and specificity of the ultrasonic sign-scoring method and MRI in the diagnosis of PA, PI, and PP were 0.757 [95% confidence interval (CI): 0.613, 0.868], 0.725 (95% CI: 0.579, 0.843), 0.989 (95% CI: 0.907, 1.000), and 0.607 (95% CI: 0.457, 0.743), 0.544 (95% CI: 0.395, 0.687), 0.614 (95% CI: 0.464, 0.749), respectively. Conclusions Although the sensitivity and specificity were lower than 0.8, the ultrasonic sign-scoring method was still superior to MRI in the detection of PI and PP. US can be used to help identify high-risk gravid women.

show abstract

“…The ultrasonic sign-scoring scale used in this study complied with the previous protocol, and details of the scored components ( 1 ) can be found in Table 1 and Figure 1 .…”

Section: Methodsmentioning

confidence: 99%