Conventional MR imaging features for predicting the clinical outcome of patients with invasive placenta
Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
Department of Interventional Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
Department of Obstetrics, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
Diagn Interv Radiol ; : -
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Purpose: To evaluate whether the morphologic magnetic resonance imaging (MRI) features could help to predict the maternal outcome after uterine artery embolization (UAE)-assisted caesarean section (CS）in patients with invasive placenta previa.
Materials and Methods: We retrospectively reviewed the MR images of 40 pregnant women who undergone UAE-assisted caesarean section due to the suspected high risk of massive haemorrhage caused by invasive placenta previa. Patients were divided into two groups based on the maternal outcome (good-outcome group: minor haemorrhage and uterus preserved; bad-outcome group: significant haemorrhage or emergency hysterectomy). Morphologic MR imaging features were compared between the two groups. Multivariate logistic regression analysis was used to identify the most valuable variables, and then the predictive value of the identified risk factor in predicting the bad maternal outcome was determined.
Results: The low signal intensity bands on T2WI (p<0.001), the placenta percreta (p=0.011), the placental cervical protrusion sign (p=0.002) were more frequently observed in patients with bad outcome. The low signal intensity bands on T2WI [Odds ratio (OR), 14.79] was the only significant predictor for bad maternal outcome (p=0.020) in multivariate analysis. Using the low signal intensity bands on T2WI to predict the bad maternal outcome, the following predictive performance could be achieved (Sensitivity 81.3%, Specificity 84.3%).
Conclusions: The low signal intensity bands on T2WI might be a predictor for bad maternal outcome after UAE-assisted caesarean section in patients with invasive placenta previa.