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Quantifying magnetic resonance imaging features to classify placenta accreta spectrum (PAS) in high-risk gravid patients

  • Caiting Chu
    Affiliations
    Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China
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  • Ming Liu
    Affiliations
    Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China
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  • Yuzheng Zhang
    Affiliations
    Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China
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  • Lingwei Yu
    Affiliations
    Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China
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  • Dengbin Wang
    Affiliations
    Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China
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  • Chengjin Gao
    Correspondence
    Corresponding author.
    Affiliations
    Department of Emergency, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China
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  • Wenhua Li
    Correspondence
    Correspondence to: W. Li, Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China.
    Affiliations
    Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China

    Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Chongming Branch, 25 South Gate Road, Shanghai 202150, China
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      Highlights

      • MRI features of placenta accreta spectrum in high-risk gravid patients were comprehensively analysed and compared.
      • Based on different value of MRI features, PAS were scored and classified.
      • The level of scores reflected to the severity of PAS.

      Abstract

      Objective

      This study aimed to quantify the magnetic resonance imaging (MRI) features of placenta accreta spectrum (PAS) and to use MRI-based scores to classify them in high-risk gravid patients.

      Materials and methods

      The clinical data and MRI features of 65 high-risk gravid patients diagnosed with PAS were retrospectively reviewed. The MRI features of PAS were analysed and compared using the chi-squared test, and the odds ratios (ORs) for significant risk factors for classification of PAS were identified via a multivariate logistic regression model. A receiver-operating characteristic (ROC) curve was used to calculate cut-off values and their corresponding sensitivity, specificity, and accuracy in classifying PAS.

      Results

      We identified 3 significant risk features for classification of PAS, including placental heterogeneity (OR = 13.604), abnormal vascularization at the placental-maternal interface (OR = 9.528), and focal myometrial interruption (OR = 118.779). The significant risk features for classification of PAS were scored according to their OR values, as 3 points (OR ≥ 20), 2 points (10 ≤ OR < 20), or 1 point (OR < 10). Based on the scores of the 3 risk features, a cut-off score of 4.5 points achieved optimal sensitivity (94.3%), specificity (90%), and accuracy (92.3%) for classifying PAS in high-risk gravid patients.

      Conclusion

      Quantifying these MRI features including placental heterogeneity, abnormal vascularization at the placental-maternal interface, and focal myometrial interruption can make a classification of PAS in high-risk gravid patients.

      Keywords

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