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European Radiology
Published in: European Radiology 9/2011

01-09-2011 | Urogenital

Magnetic resonance imaging of clinically stable late pregnancy bleeding: beyond ultrasound

Authors: Gabriele Masselli, Roberto Brunelli, Tiziana Parasassi, Giuseppina Perrone, Gianfranco Gualdi

Published in: European Radiology | Issue 9/2011

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Abstract

Objectives

To compare the accuracy of magnetic resonance (MRI) and colour Doppler-ultrasound (US) in the diagnosis of late pregnancy bleeding and to assess the accuracy of the different MR sequences in visualizing the origin of haemorrhage.

Methods

42 patients in the third trimester of pregnancy underwent to US and MRI for the evaluation of painless vaginal bleeding. Multiplanar HASTE, True Fisp, 3D T1 GRE and sagittal DWI sequences were acquired. Two radiologists, blinded to the results of US, reviewed each case, resolving by consensus any discrepancy. Reference standards were surgical and pathological findings.

Results

The reference standards identified 22 placenta previa, 11 placental abruptions (1 coincident with a placental chorioangioma), 1 thrombohaematoma and 1 fibroma with haemorrhagic degeneration. MRI identified correctly all these condition with an interobserver agreement of 0.955. DWI and T1 weighted sequences were statistically superior to Haste and True Fisp sequences in detecting the cause of bleeding (p < .001). US had 6 false negatives and 2 false positive results, its diagnostic accuracy resulting lower than MRI (p = .001).

Conclusions

MRI accurately evaluates pregnancy bleeding with an excellent interobserver agreement and can grant new and additional data when US is negative.
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Metadata
Title
Magnetic resonance imaging of clinically stable late pregnancy bleeding: beyond ultrasound
Authors
Gabriele Masselli
Roberto Brunelli
Tiziana Parasassi
Giuseppina Perrone
Gianfranco Gualdi
Publication date
01-09-2011
Publisher
Springer-Verlag
Published in
European Radiology / Issue 9/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2120-8

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