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. 2024 Jul;49(7):2525-2533.
doi: 10.1007/s00261-024-04272-1. Epub 2024 Mar 7.

The MRI estimations of placental volume, T2 dark band volume, and cervical length correlate with massive hemorrhage in patients with placenta accreta spectrum disorders

Yongfei Yue  1 , Ye Song  2 , Liping Zhu  1 , Duo Xu  3 , Zhencheng Li  3 , Chengfeng Liu  1 , Baoquan Liang  1 , Yanli Lu  4
Affiliations

The MRI estimations of placental volume, T2 dark band volume, and cervical length correlate with massive hemorrhage in patients with placenta accreta spectrum disorders

Yongfei Yue et al. Abdom Radiol (NY). 2024 Jul.

Abstract

Purpose: To identify whether placental volume, T2 dark band volume, and cervical length measured by MRI correlate with massive hemorrhage (MH) in patients with placenta accreta spectrum (PAS) disorders.

Methods: A total of 163 pregnant women with PAS underwent preoperative MRI examination were divided into MH group and non-MH group. The placental volume, T2 dark band volume, and cervical length of PAS patients were measured and evaluated their ability to identify MH in patients with PAS.

Results: Patients with MH had a significantly larger placental volume, larger T2 dark band volume, and shorter cervical length than patients without MH (all P < 0.001). Multivariable logistic regression showed that placental volume (> 890 cm3), T2 dark band volume (> 35 cm3), and cervical length (< 30 mm) were significant independent risk factor in identification of MH. In all PAS patients, a positive linear correlation was found between placental volume and amount of blood loss (r = 0.527), and between T2 dark band volume and amount of blood loss (r = 0.642), and a negative linear correlation was found between cervical length and amount of blood loss (r = - 0.597). When combined with the three MRI indicators, the sensitivity and specificity in identifying cases at high risk for MH were 91.638% and 94.051%, respectively, with area under the curve (AUC) of 0.923.

Conclusion: The placental volume, T2 dark band volume, and cervical length might be used to predict MH in patients with PAS.

Keywords: Cervical length; Magnetic resonance imaging; Placenta accreta spectrum; Placental volume; T2 dark band volume.

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References

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