Placenta Accreta Spectrum (PAS) Disorder: Ultrasound versus Magnetic Resonance Imaging
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Population
2.2. Imaging Acquisition
2.3. Imaging Analysis
2.4. Definitive Diagnosis
2.5. Statistical Analysis
3. Results
3.1. Absence/Presence of PAS
3.2. Diagnosing Grade of PAS
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics and Risk Factors | No PAS | Accreta | Increta | Percreta | p-Value |
---|---|---|---|---|---|
Number of patients (%) | 79 (75) | 14 (13) | 7 (6.7%) | 4 (3.8%) | |
Mean age (SD) 1 | 37 (5.5) | 38 (5.6) | 40 (7.5) | 38 (8) | 0.73 |
No previous cesarean (%) | 48 (60.8) | 2 (14.3) | 1 (14.3) | 0 | <0.001 |
1 previous cesarean (%) | 24 (30.4) | 7 (50) | 2 (28.6) | 0 | <0.001 |
2 previous cesareans (%) | 5 (6.3) | 3 (21.4) | 1 (14.3) | 3 (75) | <0.001 |
>2 previous cesareans (%) | 2 (2.5) | 2 (14.3) | 3 (42.8) | 1 (25) | <0.001 |
Major placenta previa (%) | 45 (60) | 11 (78.6) | 7 (100) | 4 (100) | 0.02 |
Minor placenta previa (%) | 34 (43) | 3 (21.4) | 0 | 0 | 0.02 |
Previous courettage (%) | 25 (31.6) | 4 (28.6) | 1 (14.3) | 2 (50) | 0.64 |
No previous courettage (%) | 54 (68.4) | 10 (71.4) | 6 (85.7) | 2 (50) | 0.64 |
Variable | Coefficient | SD 1 | p Value |
---|---|---|---|
Intercept | −3.95 | 0.87 | <0.001 |
Previous CS 2 | 1.20 | 0.33 | <0.001 |
Previous courettage | −0.08 | 0.041 | 0.83 |
Previous myomectomy | 2.87 | 1.38 | 0.03 |
Major placenta previa | 1.9 | 0.82 | 0.02 |
US Diagnosis | MRI Diagnosis | ||||
---|---|---|---|---|---|
Histological/ Surgical diagnosis | No PAS | PAS | No PAS | PAS | |
NO PAS (%) | 70 (88.6) | 9 (11.4) | 70 (88.6) | 9 (11.4) | |
PAS (%) | 2 (8) | 23 (92) | 3 (12) | 22 (88) |
US | MRI | |
---|---|---|
Accuracy | 0.89 | 0.88 |
Sensitivity | 0.92 | 0.88 |
Specificity | 0.89 | 0.89 |
PPV 1 | 0.72 | 0.71 |
NPV 2 | 0.97 | 0.95 |
US Diagnosis | MRI Diagnosis | ||||||||
---|---|---|---|---|---|---|---|---|---|
Histological/ Surgical diagnosis | No PAS | Accreta | Increta | Percreta | No PAS | Accreta | Increta | Percreta | |
No PAS (%) | 70 (88.6) | 9 (11.4) | 0 | 0 | 70 (88.6) | 9 (11.4) | 0 | 0 | |
Accreta (%) | 2 (14.3) | 12 (85.7) | 0 | 0 | 2 (14.3) | 10 (71.4) | 2 (14.3) | 0 | |
Increta (%) | 0 | 3 (42.8) | 2 (28.6) | 2 (28.6) | 1 (14.3) | 4 (57.1) | 0 | 2 (28.6) | |
Percreta (%) | 0 | 0 | 0 | 4 (100) | 0 | 1 (25) | 0 | 3 (75) |
Anterior | Posterior | Total | ||
---|---|---|---|---|
US: PAS/no-PAS distinction | Error (%) | 5 (5.8) | 6 (33.3) | 11 (10.6) |
Correct (%) | 81 (92.2) | 12 (66.7) | 93 (89.4) | |
Total | 86 | 18 | 104 | |
Accuracy for anterior placenta | Accuracy for posterior placenta | Difference significance (chi-squared test) | ||
0.94 | 0.67 | p = 0.0024 | ||
MRI: PAS/no-PAS distinction | Error (%) | 6 (7) | 6 (33.3) | 12 (11.5) |
Correct (%) | 80 (93) | 12 (66.7) | 92 (88.5) | |
Total | 86 | 18 | 104 | |
Accuracy for anterior placenta | Accuracy for posterior placenta | Difference significance (chi-squared test) | ||
0.93 | 0.67 | p = 0.0055 |
Anterior | Posterior | Total | ||
---|---|---|---|---|
US | Error (%) | 9 (10.5) | 7 (38.9) | 16 (15.4) |
Correct (%) | 77 (89.5) | 11 (61.1) | 88 (84.6) | |
Total | 86 | 18 | 104 | |
Accuracy for anterior placenta | Accuracy for posterior placenta | Difference significance (chi-squared test) | ||
0.89 | 0.61 | p = 0.0074 | ||
MRI | Error (%) | 13 (15.1) | 8 (44.4) | 21 (20.2) |
Correct (%) | 73 (84.9) | 10 (55.6) | 83 (79.8) | |
Total | 86 | 18 | 104 | |
Accuracy for anterior placenta | Accuracy for posterior placenta | Difference significance (chi-squared test) | ||
0.85 | 0.55 | p = 0.0126 |
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Faralli, I.; Del Negro, V.; Chinè, A.; Aleksa, N.; Ciminello, E.; Piccioni, M.G. Placenta Accreta Spectrum (PAS) Disorder: Ultrasound versus Magnetic Resonance Imaging. Diagnostics 2022, 12, 2769. https://doi.org/10.3390/diagnostics12112769
Faralli I, Del Negro V, Chinè A, Aleksa N, Ciminello E, Piccioni MG. Placenta Accreta Spectrum (PAS) Disorder: Ultrasound versus Magnetic Resonance Imaging. Diagnostics. 2022; 12(11):2769. https://doi.org/10.3390/diagnostics12112769
Chicago/Turabian StyleFaralli, Ida, Valentina Del Negro, Alessandra Chinè, Natalia Aleksa, Enrico Ciminello, and Maria Grazia Piccioni. 2022. "Placenta Accreta Spectrum (PAS) Disorder: Ultrasound versus Magnetic Resonance Imaging" Diagnostics 12, no. 11: 2769. https://doi.org/10.3390/diagnostics12112769
APA StyleFaralli, I., Del Negro, V., Chinè, A., Aleksa, N., Ciminello, E., & Piccioni, M. G. (2022). Placenta Accreta Spectrum (PAS) Disorder: Ultrasound versus Magnetic Resonance Imaging. Diagnostics, 12(11), 2769. https://doi.org/10.3390/diagnostics12112769