MRI evaluation of the placenta from normal variants to abnormalities of implantation and malignancies

Zaghal, Arwa A.; Hussain, Hero K.; Berjawi, Ghina

doi:10.1002/jmri.26764

Cited by 30 publications

(21 citation statements)

References 85 publications

(258 reference statements)

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“…The purpose of MRI for possible PAS patients suspected by ultrasound should be to provide additional helpful information such as the extent and degree of placental invasion, the presence of extrauterine involvement and to predict the emergency situation during the operation process (such as blood loss, transfusion and hysterectomy) and thus help to improve the care of patients with PAS disorders in higher-level medical centers. However, with the increase of gestational weeks, myometrial thinning and placental signal heterogeneity, the signs indicating PAS disorders on MRI become harder to evaluate and more dependent on the experience of radiologists [13].…”

Section: Introductionmentioning

confidence: 99%

Radiomics analysis of placenta on T2WI facilitates prediction of postpartum haemorrhage: A multicentre study

Yao

Liu

et al. 2019

EBioMedicine

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BackgroundIdentification of pregnancies with postpartum haemorrhage (PPH) antenatally rather than intrapartum would aid delivery planning, facilitate transfusion requirements and decrease maternal complications. MRI has been increasingly used for placenta evaluation. Here, we aim to build a nomogram incorporating both clinical and radiomic features of placenta to predict the risk for PPH in pregnancies during caesarian delivery (CD).MethodsA total of 298 pregnant women were retrospectively enrolled from Henan Provincial People's Hospital (training cohort: n = 207) and from The Third Affiliated Hospital of Zhengzhou University (external validation cohort: n = 91). These women were suspected with placenta accreta spectrum (PAS) disorders and underwent MRI for placenta evaluation. All of them underwent CD and were singleton. PPH was defined as more than 1000 mL estimated blood loss (EBL) during CD. Radiomic features were selected based on their correlations with EBL. Radiomic, clinical, radiological, clinicoradiological and clinicoradiomic models were built to predict the risk of PPH for each patient. The model with the best prediction performance was validated with its discrimination ability, calibration curve and clinical application.FindingsThirty-five radiomic features showed strong correlation with EBL. The clinicoradiomic model resulted in the best discrimination ability for risk prediction of PPH, with AUC of 0.888 (95% CI, 0.844–0.933) and 0.832 (95% CI, 0.746–0.913), sensitivity of 91.2% (95% CI, 85.8%-96.7%) and 97.6% (95% CI, 92.7%-100%) in the training and validation cohort respectively. For patients with severe PPH (EBL more than 2000 mL), 53 out of 55 pregnancies (96.4%) in the training cohort and 18 out of 18 (100%) pregnancies in the validation cohort were identified by the clinicoradiomic model. The model performed better in patients without placenta previa (PP) than in patients with PP, with AUC of 0.983 compared with 0.867, sensitivity of 100% compared with 90.8% in the training cohort, AUC of 0.832 compared with 0.815, sensitivity of 97.6% compared with 97.2% in the validation cohort.InterpretationThe clinicoradiomic model incorporating both prenatal clinical factors and radiomic signature of placenta on T2WI showed good performance for risk prediction of PPH. The predictive model can identify severe PPH with high sensitivity and can be applied in patients with and without PP.

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Section: Introductionmentioning

confidence: 99%

Radiomics analysis of placenta on T2WI facilitates prediction of postpartum haemorrhage: A multicentre study

Yao

Liu

et al. 2019

EBioMedicine

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“…For prediction of parametrial, bladder, and cervical invasion, MRI has 100% specificity [ 16 ]. Therefore, MRI has an important role in confirmation of morbidly adherent placenta to enable precise mapping of placental abnormalities and aid multidisciplinary planning and management [ 17 ]. There are limited reports with regard to use of MRI in mid-trimester pregnancy for diagnosing this condition.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Rupture in a Non-Laboring Uterus at 20 Weeks: A Case Report

et al. 2020

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“…The most frequently used sequences for placental evaluation are single-shot fast spin-echo/turbo spin-echo (ssFSE/ssTSE), half-Fourier acquisition single-shot turbo spin-echo (HASTE) T2-weighted, and balanced steady-state free-precession (true FISP or FIESTA). Zaghal et al described the protocols and techniques involved in his recent review article of MRI evaluation of the placenta [2].…”

Section: How Is Placenta Accreta Diagnosed?mentioning

confidence: 99%

How and why should the radiologist look at the placenta?

Siauve

2019

Eur Radiol

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This editorial comment refers to the article "Identification of suspicious invasive placentation based on clinical MRI data using textural features and automated machine learning" by Sun et al. in European Radiology. Key Points • Understanding how the placenta works is one of the major challenges facing radiologists. • New perspectives are opening up for MRI studies of the placenta. • The authors propose a new approach to placental MRI based on texture analysis and machine learning. Keywords Magnetic resonance imaging. Placenta. Artificial intelligence Abbreviations AI Artificial intelligence FGR Fetal growth retardation FIESTA Fast imaging employing steady-state acquisition FISP Fast imaging with steady-state precession HASTE Half-acquisition turbo spin-echo ML Machine learning TA Texture analysis

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MRI evaluation of the placenta from normal variants to abnormalities of implantation and malignancies

Cited by 30 publications

References 85 publications

Radiomics analysis of placenta on T2WI facilitates prediction of postpartum haemorrhage: A multicentre study

Radiomics analysis of placenta on T2WI facilitates prediction of postpartum haemorrhage: A multicentre study

Spontaneous Rupture in a Non-Laboring Uterus at 20 Weeks: A Case Report

How and why should the radiologist look at the placenta?

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