Assessment of placental abruption with diffusion‐weighted imaging

Abstract

Aim: To investigate whether placental abruption without fetal distress could be assessed by apparent diffusion coefficient (ADC) values in magnetic resonance imaging (MRI). Methods: We conducted a retrospective case-control study at a single center. ADC values at the lesions of placental abruption in the abruption group (n = 8) were compared to those in the control group (n = 32). In the abruption group, ADC values at the sites of abruption were also compared to those at the nonabruption sites within the same placenta. Results: The ADC values in the placental area above the abruption site in the abruption group showed lower values than those in the control group when the slice containing the umbilical cord insertion site was set as the reference, and those values were compared in each corresponding slice. Compared with average ADC values, those above the abruption site in the abruption group were also significantly lower than those in the control group (p < 0.001). Furthermore, ADC values at the area above abruption were lower than those at the nonabruption area of all planes in the abruption group. Conclusions: ADC values at the lesions above the placental abruption site were reduced compared to those in the normal placenta and those in the nonabruption area. Thus, it would be helpful to understand the pathophysiology of placental abruption in expectant management, although further investigations would be needed.

The potential value of pre-delivery hematologic index in patients with placental abruption and perinatal outcomes

“…Although ultrasonography offers relatively high overall accuracy of nearly 90% for diagnosing placental abruption, its sensitivity may be only 57.0% [18].Further research should explore how to improve the diagnostic performance of ultrasonography for detecting or predicting placental abruption. It may also be possible to diagnose or predict the complication using magnetic resonance imaging [19].…”

Imaging of Acute Abdominopelvic Pain in Pregnancy and Puerperium—Part I: Obstetric (Non-Fetal) Complications

“…US is still the first modality of choice for placental assessment, because of its safety and availability. However the overall diagnostic performance of US in the detection of PA is poor, with reported sensitivity of less than 25% and a negative predictive value from 14 to 53% [ 55 , 56 , 57 ]. The US appearance of PA correlates with the size and location of the bleeding, as well as the time elapsed between abruption and the examination.…”

“…The authors demonstrated that ADC values on the lesions above the PA site were significantly reduced compared to those in the control group. Moreover, in the abruption group, ADC values at the abruption site were also significantly lower than in the non-abruption site within the same placenta [ 57 ].…”