دورية أكاديمية
Magnetic resonance imaging improves diagnosis of placenta accreta spectrum requiring hysterectomy compared to ultrasound.
| العنوان: | Magnetic resonance imaging improves diagnosis of placenta accreta spectrum requiring hysterectomy compared to ultrasound. |
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| المؤلفون: | Do QN; Research Division, Department of Radiology, University of Texas (UT) Southwestern Medical Center, Dallas, TX (Drs Do, Xi, Lewis, Fei, and Twickler)., Herrera CL; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX (Drs Herrera, Rosenthal, Spong, and Twickler); Parkland Health and Hospital System, Dallas, TX (Drs Herrera, Rosenthal, Spong, and Twickler)., Rosenthal EA; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX (Drs Herrera, Rosenthal, Spong, and Twickler); Parkland Health and Hospital System, Dallas, TX (Drs Herrera, Rosenthal, Spong, and Twickler)., Xi Y; Research Division, Department of Radiology, University of Texas (UT) Southwestern Medical Center, Dallas, TX (Drs Do, Xi, Lewis, Fei, and Twickler)., Uddin N; Department of Pathology, UT Southwestern Medical Center, Dallas, TX (Dr Uddin)., Lewis MA; Research Division, Department of Radiology, University of Texas (UT) Southwestern Medical Center, Dallas, TX (Drs Do, Xi, Lewis, Fei, and Twickler)., Fei B; Research Division, Department of Radiology, University of Texas (UT) Southwestern Medical Center, Dallas, TX (Drs Do, Xi, Lewis, Fei, and Twickler); Department of Bioengineering, The University of Texas at Dallas, Richardson, TX (Dr Fei); Center for Imaging and Surgical Innovation, The University of Texas at Dallas, TX (Dr Fei)., Spong CY; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX (Drs Herrera, Rosenthal, Spong, and Twickler); Parkland Health and Hospital System, Dallas, TX (Drs Herrera, Rosenthal, Spong, and Twickler)., Twickler DM; Research Division, Department of Radiology, University of Texas (UT) Southwestern Medical Center, Dallas, TX (Drs Do, Xi, Lewis, Fei, and Twickler); Parkland Health and Hospital System, Dallas, TX (Drs Herrera, Rosenthal, Spong, and Twickler). Electronic address: diane.twickler@utsouthwestern.edu. |
| المصدر: | American journal of obstetrics & gynecology MFM [Am J Obstet Gynecol MFM] 2024 Mar; Vol. 6 (3), pp. 101280. Date of Electronic Publication: 2024 Jan 10. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't; Research Support, N.I.H., Extramural |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101746609 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2589-9333 (Electronic) Linking ISSN: 25899333 NLM ISO Abbreviation: Am J Obstet Gynecol MFM Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [New York, NY] : Elsevier Inc., [2019]- |
| مواضيع طبية MeSH: | Placenta Accreta*/diagnostic imaging , Placenta Accreta*/surgery, Pregnancy ; Infant, Newborn ; Female ; Humans ; Retrospective Studies ; Ultrasonography, Prenatal/methods ; Hysterectomy/methods ; Ultrasonography ; Magnetic Resonance Imaging/methods |
| مستخلص: | Background: Magnetic resonance imaging has been used increasingly as an adjunct for ultrasound imaging for placenta accreta spectrum assessment and preoperative surgical planning, but its value has not been established yet. The ultrasound-based placenta accreta index is a well-validated standardized approach for placenta accreta spectrum evaluation. Placenta accreta spectrum-magnetic resonance imaging markers have been outlined in a joint guideline from the Society of Abdominal Radiology and the European Society of Urogenital Radiology. Objective: This study aimed to compare placenta accreta spectrum-magnetic resonance imaging parameters with the ultrasound-based placenta accreta index in pregnancies at high risk for placenta accreta spectrum and to assess the additional diagnostic value of magnetic resonance imaging for placenta accreta spectrum that requires a cesarean hysterectomy. Study Design: This was a single-center, retrospective study of pregnant patients who underwent magnetic resonance imaging, in addition to ultrasonography, because of suspected placenta accreta spectrum. The ultrasound-based placenta accreta index and placenta accreta spectrum-magnetic resonance imaging parameters were obtained. Student's t test and Fisher's exact test were used to compare the groups in terms of the primary outcome (hysterectomy vs no hysterectomy). The diagnostic performance of magnetic resonance imaging and the ultrasound-based placenta accreta index was assessed using multivariable logistic regressions, receiver operating characteristics curves, the DeLong test, McNemar test, and the relative predictive value test. Results: A total of 82 patients were included in the study, 41 of whom required a hysterectomy. All patients who underwent a hysterectomy met the International Federation of Gynecology and Obstetrics clinical evidence of placenta accreta spectrum at the time of delivery. Multiple parameters of the ultrasound-based placenta accreta index and placenta accreta spectrum-magnetic resonance imaging were able to predict hysterectomy, and the parameter of greatest dimension of invasion by magnetic resonance imaging was the best quantitative predictor. At 96% sensitivity for hysterectomy, the cutoff values were 3.5 for the ultrasound-based placenta accreta index and 2.5 cm for the greatest dimension of invasion by magnetic resonance imaging. Using this sensitivity, the parameter of greatest dimension of invasion measured by magnetic resonance imaging had higher specificity (P=.0016) and a higher positive predictive value (P=.0018) than the ultrasound-based placenta accreta index, indicating an improved diagnostic threshold. Conclusion: In a suspected high-risk group for placenta accreta spectrum, magnetic resonance imaging identified more patients who will not need a hysterectomy than when using the ultrasound-based placenta accrete index only. Magnetic resonance imaging has the potential to aid patient counseling, surgical planning, and delivery timing, including preterm delivery decisions for patients with placenta accreta spectrum requiring hysterectomy. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
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| معلومات مُعتمدة: | K23 HD103876 United States HD NICHD NIH HHS; K25 HD104004 United States HD NICHD NIH HHS; L30 HD109864 United States HD NICHD NIH HHS |
| فهرسة مساهمة: | Keywords: MRI; hysterectomy; placenta accreta index; placenta accreta spectrum; ultrasound |
| تواريخ الأحداث: | Date Created: 20240112 Date Completed: 20240320 Latest Revision: 20240815 |
| رمز التحديث: | 20240815 |
| مُعرف محوري في PubMed: | PMC11070455 |
| DOI: | 10.1016/j.ajogmf.2024.101280 |
| PMID: | 38216054 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2589-9333 |
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| DOI: | 10.1016/j.ajogmf.2024.101280 |