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| The imaging characteristics and value of MRI examination used for diagnosing of pregnant women with dangerous placenta previa and placenta accreta |
| Li Huili East Hospital of Ningbo Medical Center, Zhejiang Province, 315000 |
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Abstract To analyze the imaging characteristics of MRI used for diagnosing pregnant women with dangerous placenta previa (PPP) and placenta accreta, and to explore the clinical value of MRI examination. Methods: The data of 71 pregnant women with PPP admitted to li Huili east hospital from December 2015 to December 2017 were analyzed retrospectively. All patients were examined by prenatal B ultrasound and MRI before delivery. Imaging features of MRI examination of pregnant women with placenta accreta was analyzed. The diagnosing value of pregnant women with placenta accrete were compared between MRI examination and B ultrasound based on placenta pathology of women after delivery. Results: There were 25 women without placenta accreta, there were 23 women with placenta adhesion, there were 25 women with placenta accreta, and there were 3 women with placenta penetrated who confirmed by placenta pathology. As for diagnosed by MRI, the signs of 50.7% women were unclear in the demarcation of placenta and uterus, 46.5% women had intra-placental signal inhomogeneity, 32.4% women had increasing and thickening of intra-placental vascular shadows, 28.17% women had T2W1 banded low signal shadow, 15.49% women had bladder shape with tent-like or nodular, and 11.27% women had partial bulge of uterus. The correct rate of diagnosing placenta accreta by MRI examination was 84.00%, in which, the correct rate of diagnosing placental adhesion, placenta accrete, and placenta penetration were 87.0%, 90%, and 100.0%, respectively. When diagnosis of placenta accreta by MRI examination only, the sensitivity of T2W1 low signal band was the highest, which was 61.3%, the specificity and positive predictive value of uterine local protrusion were the highest (96.4% and 100.00%, respectively), and the negative predictive value of placenta vascular shadow was the highest (61.5%). The sensitivity, specificity, positive predictive value, and negative predictive value of several image features of MRI examination for diagnosing placenta accreta were 96.37%, 98.15%, 97.05%, and 98.02%, respectively. Conclusion: MRI examination is highly valuable for diagnosing pregnant women with placenta accreta and placenta transplacent. The low signal intensity of T2W1, local uterine protrusion, and increased placental vascular shadow are important MRI image features for diagnosing placenta accreta. Several image features of MRI examination combined for diagnosing placenta accreta can increase the diagnostic accuracy.
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