Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa Plasenta Previa Olgularında Plasenta Akreta Spektrumunu (PAS) ve Klinik Sonuçları Tahmin Etmede Prenatal MRG'nin Tanısal Doğruluğunun Değerlendirilmesi
Van Medical Journal, cilt.30, sa.2, ss.133-141, 2023 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 30 Sayı: 2
- Basım Tarihi: 2023
- Doi Numarası: 10.5505/vtd.2023.98415
- Dergi Adı: Van Medical Journal
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.133-141
- Anahtar Kelimeler: intrapartum bleeding, peripartum hysterectomy, Placenta accreta spectrum, placenta previa, prenatal MRI
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: The purpose of this study is to investigate the predictive value of magnetic resonance imaging (MRI) parameters in predicting placenta accreta spectrum (PAS) and clinical outcomes of patients with placenta previa. Materials and Methods: A total of 56 prenatal placental MRI examinations acquired via 1.5 and 3 Tesla scanners were retrospectively examined by 2 radiologists in consensus. Presence of T2 dark band, thinning of myometrium, abnormal vascularization, uterine bulging, heterogeneous placenta, placental protrusion, placenta recess and percretism findings were evaluated. While pathology and clinical intrapartum findings constituted the reference standard for placenta accreta spectrum (PAS), intrapartum/peripartum bleeding over 1000 mL and emergency hysterectomy were regarded as poor clinical outcomes. The values of MRI findings in predicting both PAS and clinical outcomes were analyzed. Results: Age, (platelet) PLT value and gestational age were similar in patients with both groups. Signs of percretism had the best diagnostic test performance in predicting clinical worsening, followed by intraplacental abnormal vascularization and placental recession (respectively 80.6%, 76.4%, 73.6%). The most valuable finding in predicting PAS was percretism sign, placental recess, and myometrial thinning (respectively 85.0%, 81.3%, 79.4%). Conclusion: Percretism and intraplacental abnormal vascularization are highly predictive of a possible poor clinical outcome.