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T2-weighted balanced steady-state free procession MRI evaluated for diagnosing placental adhesion disorder in late

Ang Yang1, Xue Hong Xiao2, Zhi Long Wang2

  • 1MR department of Affiliated Zhongshan City Hospital of Sun Yat-sen University, Sun Wendong Road No. 2, Zhongshan City, Guangdong Province, China. yang19781230@gmail.com.

European Radiology
|April 14, 2018
PubMed
Abstract

Insights

T2-weighted (T2W) balanced steady-state free procession (b-SSFP) MRI shows superior accuracy for diagnosing placental adhesion disorder (PAD) compared to other sequences. This advanced imaging technique offers higher signal-to-noise ratio and reduced blur for improved diagnostic capabilities.

Area of Science:

  • Radiology
  • Obstetrics & Gynecology
  • Medical Imaging

Background:

  • Placental adhesion disorder (PAD) poses significant risks during pregnancy.
  • Accurate diagnosis of PAD is crucial for effective management.
  • Conventional MRI sequences may have limitations in visualizing PAD characteristics.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of T2-weighted (T2W) balanced steady-state free procession (b-SSFP) MRI for PAD.
  • To compare T2W b-SSFP with standard b-SSFP and single-shot fast spin echo (SSFSE) sequences.
  • To identify specific imaging features indicative of PAD across different MRI sequences.

Main Methods:

  • Fifty-one pregnant patients with suspected PAD underwent MRI using T2W b-SSFP, b-SSFP, and SSFSE sequences.
  • Images were analyzed for abnormal placental bulge (APB), dark intraplacental bands (DIB), placental heterogeneity (PH), and placental protrusion into adjacent structures (PPAS).
  • Sequences were compared based on muscle-to-placenta signal ratio, PAD sign detection rates, and area under the receiver operating characteristic curve (AUC).

Main Results:

  • T2W b-SSFP demonstrated the highest muscle-to-placenta signal ratio.
  • Diagnostic rates for APB and PH were significantly higher with T2W b-SSFP compared to SSFSE.
  • The AUC for T2W b-SSFP (0.966) was superior to b-SSFP (0.890) and SSFSE (0.823), indicating higher diagnostic accuracy for PAD.

Conclusions:

  • T2W b-SSFP MRI offers high diagnostic accuracy for placental adhesion disorder.
  • The superior performance is attributed to T2W b-SSFP's high signal-to-noise ratio, T2-weighting, and reduced motion artifact.
  • T2W b-SSFP is a valuable tool for diagnosing PAD, outperforming conventional b-SSFP and SSFSE sequences.
Keywords:
DiagnosisMagnetic resonance imagingPlacenta accretaPregnancyROC curve

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