TY - JOUR
T1 - Novel MRI finding for diagnosis of invasive placenta praevia
T2 - Evaluation of findings for 65 patients using clinical and histopathological correlations
AU - Ueno, Yoshiko
AU - Kitajima, Kazuhiro
AU - Kawakami, Fumi
AU - Maeda, Tetsuo
AU - Suenaga, Yuko
AU - Takahashi, Satoru
AU - Matsuoka, Shozo
AU - Tanimura, Kenji
AU - Yamada, Hideto
AU - Ohno, Yoshiharu
AU - Sugimura, Kazuro
N1 - Funding Information:
We wish to thank Ryoichi Hazama, MD, PhD, Hiroki Morita, MD, PhD, and Tomoo Ito, MD, PhD, for extensive support for the data analyses. Co-author Yoshiharu Ohno, MD, PhD, has a research grant from Toshiba Medical Systems.
PY - 2014/4
Y1 - 2014/4
N2 - Objective: To review established magnetic resonance (MR) criteria and describe a new MR finding for the diagnosis of invasive placenta praevia. Methods: A retrospective review of prenatal MRI examinations of 65 patients (median age: 35 years) who underwent MR for the screening of invasive placenta praevia. All MRIs were performed on a 1.5-T unit, including axial, coronal and sagittal T2-weighted half-Fourier single-shot turbo spin echo imaging. Fifteen patients were diagnosed with invasive placenta praevia. Two experienced radiologists reviewed the MR images and evaluated a total of six MRI features of the placenta, including our novel finding of the placental protrusion into the internal os (placental protrusion sign). Inter-rater reliability was assessed by using kappa statistics. Features with a kappa statistic >0.40 were evaluated using Fisher's two-sided exact test for comparison of their capabilities for placental invasion assessment. Results: Interobserver reliability was moderate or better for the intraplacental T2 dark band, intraplacental abnormal vascularity, uterine bulging, heterogeneous placenta and placental protrusion sign. Fisher's two-sided exact test results showed all these features were significantly associated with invasive placenta praevia. Conclusion: The novel MRI finding of a placental protrusion sign is a useful addition to the established MRI findings for the diagnosis of invasive placenta praevia. Key Points: • Prenatal diagnosis for an invasive placenta is essential for perinatal planning. • Magnetic resonance imaging provides useful information for the diagnosis of invasive placenta. • The placental protrusion sign is a useful novel MRI finding for predicting invasive placenta.
AB - Objective: To review established magnetic resonance (MR) criteria and describe a new MR finding for the diagnosis of invasive placenta praevia. Methods: A retrospective review of prenatal MRI examinations of 65 patients (median age: 35 years) who underwent MR for the screening of invasive placenta praevia. All MRIs were performed on a 1.5-T unit, including axial, coronal and sagittal T2-weighted half-Fourier single-shot turbo spin echo imaging. Fifteen patients were diagnosed with invasive placenta praevia. Two experienced radiologists reviewed the MR images and evaluated a total of six MRI features of the placenta, including our novel finding of the placental protrusion into the internal os (placental protrusion sign). Inter-rater reliability was assessed by using kappa statistics. Features with a kappa statistic >0.40 were evaluated using Fisher's two-sided exact test for comparison of their capabilities for placental invasion assessment. Results: Interobserver reliability was moderate or better for the intraplacental T2 dark band, intraplacental abnormal vascularity, uterine bulging, heterogeneous placenta and placental protrusion sign. Fisher's two-sided exact test results showed all these features were significantly associated with invasive placenta praevia. Conclusion: The novel MRI finding of a placental protrusion sign is a useful addition to the established MRI findings for the diagnosis of invasive placenta praevia. Key Points: • Prenatal diagnosis for an invasive placenta is essential for perinatal planning. • Magnetic resonance imaging provides useful information for the diagnosis of invasive placenta. • The placental protrusion sign is a useful novel MRI finding for predicting invasive placenta.
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U2 - 10.1007/s00330-013-3076-7
DO - 10.1007/s00330-013-3076-7
M3 - Article
C2 - 24272229
AN - SCOPUS:84896315540
VL - 24
SP - 881
EP - 888
JO - European Radiology
JF - European Radiology
SN - 0938-7994
IS - 4
ER -