Comparison between 1.5-T and 3.0-T MRI for the diagnosis of placenta accreta spectrum disorders - 12/05/22

Doi : 10.1016/j.diii.2022.04.005

Charis Bourgioti ^a,^⁎ , Konstantina Zafeiropoulou ^a, Chara Tzavara ^b, George Daskalakis ^c, Stavros Fotopoulos ^d, Marianna Theodora ^c, Maria Evangelia Nikolaidou ^d, Marianna Konidari ^a, Sofia Gourtsoyianni ^a, Evangelia Panourgias ^a, Vassilis Koutoulidis ^a, Epameinondas Anastasios Martzoukos ^e, Anastasia Evangelia Konstantinidou ^f, Lia Angela Moulopoulos ^a
^a First Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Aretaieion Hospital, Athens 11528, Greece
^b Department of Health, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens 11527, Greece
^c Department of Fetal and Maternal Medicine, First Department of Gynaecology and Obstetrics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens 11528, Greece
^d Department of Gynaecology and Obstetrics, IASO Maternity Hospital, Athens 15123, Greece
^e Department of Radiology, 401 General Army Hospital, Athens 11525, Greece
^f First Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens 11527, Greece

^⁎Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 12 May 2022
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Highlights

•	Diagnostic performance of MRI for placental invasiveness is high with no differences between 1.5 and 3.0 Tesla.
•	MRI at 1.5- and 3-T show excellent and equivalent diagnostic capabilities for detecting extrauterine placental spread.
•	MRI at 1.5-T shows similar capability for revealing signs of invasive placenta (i.e., T2-dark intraplacental bands, intraplacental fetal vessels and parenchymal heterogeneity) compared to MRI at 3-T.

Le texte complet de cet article est disponible en PDF.

Abstract

Purpose

Accurate antenatal diagnosis of placenta accreta spectrum (PAS) is important for optimal management. The purpose of this study was to compare the respective capabilities of 1.5-T and 3.0-T MRI in the diagnosis of PAS.

Materials and methods

Between March 2016-March 2021, 190 pregnant women at high risk for PAS underwent dedicated prenatal MRI with either 1.5-T or 3.0-T units at a tertiary imaging center. Cesarian section and MRI were performed less than 6 weeks from each other. Prospectively collected data were evaluated by two experienced genitourinary radiologists for presence and extent of PAS. A comparative study was designed to investigate differences in predictive ability between 1.5-T and 3.0-T MRI groups. Sensitivity, specificity, accuracy, negative and positive prognostic values relative to intraoperative/histological findings, were computed for both groups and were compared with chi-square (χ 2) test. Interobserver agreement was estimated using Kappa test.

Results

One hundred-eighty-two gravid women were included in the study; of these, 91/182 (50%) women were evaluated with 1.5-T (mean age, 35 ± 5.1 [SD] years; mean gestational age: 32.5 weeks) and 91/182 (50%) with 3.0-T MRI (mean age, 34.9 ± 4.9 [SD] years; mean gestational age, 32.1 weeks). 1.5-T MRI yielded 95.7% sensitivity (95% CI: 87.8–99.1) and 81.8% specificity (95% CI: 59.8) and 3.0-T MRI 93.8% sensitivity (95% CI: 86.0–97.9) and 83.3% specificity (95% CI: 48.2–97.7) for PAS identification, with no differences between the two groups (P = 0.725 and P >0.999, respectively). MRI showed excellent predictive ability for detecting extrauterine placental spread with 100% sensitivity (95% CI: 89.4–100.0), 96.7% specificity (95% CI: 88.1–99.6) for 1.5-T and 97% sensitivity (95% CI: 84.2–99.9), 96.7% specificity (95% CI: 88.1–99.6) for 3.0-T without differences between the two groups (P > 0.999). Interobserver agreement was excellent for both groups. The most frequently detected MRI signs of PAS for both 1.5-T and 3.0-T groups were placental heterogeneity (n = 85, 93.5% vs. n = 90, 98.9%; P = 0.413), and intraplacental fetal vessels (n = 64, 70.3% vs. n = 65, 71.4%; P = 0.870).