Functional diagnosis of placenta accreta by intravoxel incoherent motion model diffusion-weighted imaging
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MAGNETIC RESONANCE
Functional diagnosis of placenta accreta by intravoxel incoherent motion model diffusion-weighted imaging Yuwei Bao 1 & Ying Pang 1 & Ziyan Sun 1 & Qian Li 1 & Dazhong Tang 1 & Liming Xia 1 Received: 16 April 2020 / Revised: 21 June 2020 / Accepted: 14 August 2020 # European Society of Radiology 2020
Abstract Objectives To investigate the diagnostic value of intravoxel incoherent motion (IVIM) DWI for placenta accreta by comparing diffusion and perfusion characteristics of placentas with accreta lesions (APs) with those of normal placentas (NPs). Methods Twenty-five pregnant women with AP and 24 with NP underwent 3-T magnetic resonance examinations with IVIMDWI. The perfusion percentage ( f ), pseudo-diffusion coefficient (D*), and diffusion coefficient (D) values were calculated from different ROIs: the entire-plane of the AP (AP-ROI) and NP (NP-ROI) and the implanted (IR-ROI) and non-implanted region (NIRROI) of the AP. The AP-ROIs and NP-ROIs were compared using covariance analysis; the IR-ROIs and NIR-ROIs were compared using the Wilcoxon signed-rank test. ROC curves were produced to evaluate the parameters for predicting placenta accreta. Results The f and D* values for the AP-ROIs ([45.0 ± 7.63]%, [11.64 ± 2.15]mm2/s) were significantly higher than those for the NP-ROIs ([31.85 ± 5.96]%, [9.04 ± 3.13]mm2/s) (both p < 0.05); the IR-ROIs (54.8%, 14.03 mm2/s) were also significantly higher than the NIR-ROIs (37.4%, 11.4 mm2/s) (both p < 0.05). No significant differences were found between the D values of the AP-ROIs and NP-ROIs (p > 0.05) or of the IR-ROIs and NIR-ROIs (p > 0.05). The areas under the curve for f and D* of the ROC curves were 0.93 and 0.79, respectively. Conclusions These results suggest that the IVIM parameters f and D* can be used to quantitatively evaluate the higher perfusion of AP when compared with NP. Furthermore, IVIM may be a useful functional diagnostic technique to predict placenta accreta. Key Points • Intravoxel incoherent motion (IVIM) may be a useful diagnostic technique to quantitatively estimate the perfusion of the placenta. • The perfusion percentage (f) and pseudo-diffusion coefficient (D*) values differed significantly between placentas with accreta lesions and normal placentas. • ROC curves showed that perfusion percentage (f) and pseudo-diffusion coefficient (D*) values could accurately predict placenta accreta. Keywords Placenta accreta . Diagnostic techniques . obstetrical and gynecological . Perfusion
Abbreviations AP Placentas with accreta lesions D* Pseudo-diffusion coefficient D Diffusion coefficient f Perfusion percentage HASTE Half-Fourier acquisition single-shot turbo spin-echo ICC Intra-class correlation coefficient * Liming Xia [email protected]; [email protected] 1
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
IVIM NP TR/TE
Intravoxel incoherent motion Normal placentas Repetition time/echo time
Introduction Placenta ac
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