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01-02-2018 | Magnetic Resonance

Invasive placenta previa: Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI – useful features for differentiating placenta percreta from placenta accreta

Authors: Xin Chen, Ruiqin Shan, Lianxin Zhao, Qingxu Song, Changting Zuo, Xinjuan Zhang, Shanshan Wang, Honglu Shi, Fei Gao, Tianyi Qian, Guangbin Wang, Catherine Limperopoulos

Published in: European Radiology | Issue 2/2018

Abstract

Objectives

To characterise MRI features of invasive placenta previa and to identify specific features for differentiating placenta percreta (PP) from placenta accreta (PA).

Methods

Forty-five women with PP and 93 women with PA who underwent 1.5T placental MRI were included. Two radiologists independently evaluated the MRI features of invasive placenta previa, including our novel type of placental bulge (i.e. placental bulge type-II, characterized by placental bulge with distorted uterine outline). Pearson’s chi-squared or Fisher’s two-sided exact test was performed to compare the MRI features between PP and PA. Logistic stepwise regression analysis and the area under the receiver operating characteristic curve (AUC) were performed to select the optimal features for differentiating PP from PA.

Results

Significant differences were found in nine MRI features between women with PP and those with PA (P <0.05). Placental bulge type-II and uterine serosal hypervascularity were independently associated with PP (odds ratio = 48.618, P < 0.001; odds ratio = 4.165, P = 0.018 respectively), and the combination of the two MRI features to distinguish PP from PA yielded an AUC of 0.92 for its predictive performance.

Conclusion

Placental bulge type-II and uterine serosal hypervascularity are useful MRI features for differentiating PP from PA.

Key Points

• Placental bulge type-II demonstrated the strongest independent association with PP.

• Uterine serosal hypervascularity is a useful feature for differentiating PP from PA.

• MRI features associated with abnormal vessels increase the risk of massive haemorrhage.

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Title: Invasive placenta previa: Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI – useful features for differentiating placenta percreta from placenta accreta
Authors: Xin Chen
Ruiqin Shan
Lianxin Zhao
Qingxu Song
Changting Zuo
Xinjuan Zhang
Shanshan Wang
Honglu Shi
Fei Gao
Tianyi Qian
Guangbin Wang
Catherine Limperopoulos
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 2/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4980-z

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Invasive placenta previa: Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI – useful features for differentiating placenta percreta from placenta accreta

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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