Magnetic resonance imaging and previous cesarean section in placenta accrete spectrum disorder: Predictor model
Clinics
; 77: 100027, 2022. tab, graf
Article
in En
|
LILACS-Express
| LILACS
| ID: biblio-1375200
Responsible library:
BR1.1
ABSTRACT
Abstract Objective To evaluate objective criteria of Magnetic Resonance Imaging (MRI) of Placenta Accreta Spectrum disorder (PAS) analyzing interobserver agreement and to derive a model including imaging and clinical variables to predict PAS. Methods A retrospective review including patients submitted to MRI with suspicious findings of PAS on ultrasound. Exclusion criteria were lack of pathology or surgical information and missing or poor-quality MRI. Two radiologists analyzed six MRI features, and significant clinical data were also recorded. PAS confirmed on pathology or during intraoperative findings were considered positive for the primary outcome. Variables were tested through logistic regression models. Results Final study included 96 patients with a mean age of 33 years and 73.0% of previous C-sections. All MRI features were significantly associated with PAS for both readers. After logistic regression fit, including MRI signs with a moderate or higher interobserver agreement, intraplacental T2 dark band was the most significant radiologic criteria, and ROC analysis resulted in an AUC = 0.782. After including the most relevant clinical data (previous C-section) to the model, the ROC analysis improved to an AUC = 0.893. Conclusion Simplified objective criteria on MRI, including intraplacental T2 dark band associated with clinical information of previous C-sections, had the highest accuracy and was used for a predictive model of PAS.
Full text:
1
Collection:
01-internacional
Database:
LILACS
Type of study:
Prognostic_studies
/
Risk_factors_studies
Language:
En
Journal:
Clinics
Journal subject:
MEDICINA
Year:
2022
Document type:
Article
Affiliation country:
Brazil
Country of publication:
Brazil