US and MR imaging findings to detect placental adhesion spectrum (PAS) in patients with placenta previa: a comparative systematic study(12 visite) Romeo V, Sarno L, Volpe A, Ginocchio MI, Esposito R, Mainenti PP, Petretta M, Liuzzi R, D'Armiento M, Martinelli P, Brunetti A, Maurea S
Parole chiave: Diagnostic Accuracy, Magnetic Resonance Imaging (mri), Placenta Previa, Placental Adhesion Spectrum (pas), Ultrasound (us)
*** IBB - CNR *** Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy. firstname.lastname@example.org., Department of Neuroscience, Reproductive and Dentistry Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy., Institute of Biostructures and Bioimaging of the National Research Council (IBB-CNR), Naples, Italy., Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy.,
PURPOSE: To compare the performance US and MR in identifying placental adhesion spectrum (PAS) in placenta previa (PP) and to establish a potential method of image interpretation. METHODS: US and MR examinations of 51 patients with PP were selected. The presence of imaging signs commonly used to detect PAS was assessed. Penalized logistic regression was performed considering histology as standard of reference; only signs statistically significant (p < 0.05) were considered for ROC and multivariate analysis. The probability of PAS according to the presence of US and/or MR signs was then assessed. RESULTS: At univariate analysis, loss of retroplacental clear space, myometrial thinning (MT) and placenta lacunar spaces on US, intraplacental dark bands (IDBs), focal interruption of myometrial border (FIMB) and abnormal vascularity (AV) on MR were statistically significant (p < 0.01). Three diagnostic methods for PAS were then developed for both US and MR when at least one (Method 1), two (Method 2) or three (Method 3) imaging signs occurred, respectively. Method 2 for MR showed a significantly (p < 0.05) higher accuracy (91%) compared to the other methods. When MR IDBs and AV as well as IDBs and FIMB were present in combination with US MT the probability of PAS increased from 75 to 90% and from 80 to 91%, respectively. CONCLUSION: MR demonstrated a higher diagnostic accuracy than US to detect PAS. However, since the combination of MR and US signs could improve the probability to detect PAS, a complementary diagnostic role of these techniques could be considered.
111 Records (106 escludendo Abstract e Conferenze). Impact factor totale: 260.861 (249.76 escludendo Abstract e Conferenze). Impact factor a 5 anni totale: 319.669 (306.14 escludendo Abstract e Conferenze).