Magnetic resonance imaging and previous cesarean section in placenta accrete spectrum disorder: Predictor model

Polizio, Rodrigo Pamplona; Yamauchi, Fernando Ide; Mendes, Renata Franco Pimentel; Peres, Stela Verzinhasse; Kondo, Marcel Yuzo; Francisco, Rossana Pulcineli Vieira

doi:10.1016/j.clinsp.2022.100027

Cited by 2 publications

(2 citation statements)

References 38 publications

(73 reference statements)

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“…It is a comparative study in which findings of MRI are compared with CS findings and the parameter that are measure of diagnostic efficacy are calculated. The sensitivity of MRI was observed to be 97% , while specificity was observed to be 79% in the present study 17 . In a study conducted by Iqtadar et al, the sensitivity was observed to be 84%.…”

Section: Discussionsupporting

confidence: 45%

Role of MRI in Detecting Abnormal Placentation in Patients with Strong Ultrasound Concern for Myometrial Invasion

Afridi¹,

Orakzai²,

Yasmeen³

et al. 2022

PJMHS

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Abnormal placentation has raised the ratio of cesarean cases. In such obstetric complication the placenta lie at the lower segment of the uterus. These abnormal attachments of placenta to uterus and invasion to adjacent organs are the main cause of placenta previa. These are not only raising delivery challenges but also raising the mortality cases. Objective: For evaluation of the diagnostic efficacy of MRI to locate placentation abnormalities with high accuracy and sensitivity. This not only helps in preoperative delivery planning but also decreases the ratio of mortality. Study Setting: It was an observational study, conducted at radiology department of Mardan Medical Complex Mardan for the duration of six months from September 2021 to February 2022. Methods: The women suspicion of placentation abnormalities were recommended with MRI. The consecutive 185 pregnant women were included in the study. The results obtained from MRI were compared with the results obtained by C-section. Cesarean section results were considered as standard. The treatment strategy was decided in accordance with the MRI findings. The treatment strategies which opt during the CS were compared with the strategy created on the basis of MRI. Results: 115 women were diagnosed with abnormal placentation. The 70 women out of 185 were diagnosed with placenta previa. The percentage false results were seen in 18 patients. The false negative results of MRI were seen in three patients. After comparison between the findings of MRI and CS the sensitivity, positive predictive values and other parameters were calculated. The sensitivity was 97%, while the positive predictive value was 84%. The other parameters such as specificity were 79% and negative predictive value was 95%. The sensitivity, accuracy, and positive predictive values of the planning strategy created for treatment on the basis of MRI findings were calculated. There was significant correlation between the findings of MRI and CS. Conclusion: For the future planning of treatment strategy for the women suspected of abnormal placentation, MRI is highly suggested diagnostic tool with better efficacy and sensitivity. This imaging modality helps in proper and accurate diagnosis of abnormal placentation. Keywords: Abnormal placentation, obstetric complications, treatment strategy, placenta previa.

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Section: Discussionsupporting

confidence: 45%

Role of MRI in Detecting Abnormal Placentation in Patients with Strong Ultrasound Concern for Myometrial Invasion

Afridi¹,

Orakzai²,

Yasmeen³

et al. 2022

PJMHS

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“…To boost the diagnostic accuracy, particularly for suspected PAS, many obstetricians request MRI examinations in addition to US examinations, as MRI has a higher resolution in the screening of soft tissues ( 2 , 5 ). However, it is not yet known whether MRI is more accurate and informative than the ultrasonic sign-scoring method in the diagnosis of PAS.…”

Section: Introductionmentioning

confidence: 99%

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

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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.

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Magnetic resonance imaging and previous cesarean section in placenta accrete spectrum disorder: Predictor model

Cited by 2 publications

References 38 publications

Role of MRI in Detecting Abnormal Placentation in Patients with Strong Ultrasound Concern for Myometrial Invasion

Role of MRI in Detecting Abnormal Placentation in Patients with Strong Ultrasound Concern for Myometrial Invasion

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

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