Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa

İzgi, Nedim; Gulek, Bozkurt; TAS, Zeynel Abidin; Akkaya, Hüseyin

Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa

Hüseyin AKKAYA, (Sağlık Bilimleri Üniversitesi, Adana Şehir Eğitim ve Araştırma Hastanesi, Radyoloji Anabilim Dalı, Adana, TÜRKİYE)

Nedim İZGİ, (Sağlık Bilimleri Üniversitesi, Adana Şehir Eğitim ve Araştırma Hastanesi, Radyoloji Anabilim Dalı, Adana, TÜRKİYE)

Zeynel Abidin TAŞ, (Sağlık Bilimleri Üniversitesi, Adana Şehir Eğitim ve Araştırma Hastanesi, Patoloji Kliniği, Adana, TÜRKİYE)

Bozkurt GÜLEK (Sağlık Bilimleri Üniversitesi, Adana Şehir Eğitim ve Araştırma Hastanesi, Radyoloji Anabilim Dalı, Adana, TÜRKİYE)

Van Tıp Dergisi

7 3

Yıl: 2023 Cilt: 30 Sayı: 2 Sayfa Aralığı: 133 - 141 Metin Dili: İngilizce İndeks Tarihi: 12-05-2023

Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa

Öz:

Introduction: The purpose of this study is to investigate the predictive value of magnet ic resonance imaging (MRI) parameters in predicting placenta accreta spectrum (PAS) and clinical outcomes of patients with placenta previa. Materials and Methods: A total of 56 prenatal placental MRI examinations acquired via 1.5 and 3 Tesla scanners were retrospectively examined by 2 radiologists in consensus. Presence of T2 dark band, th inning of myometrium, abnormal vascularization, uterine bulging, heterogeneous placenta, placental protrusion, placenta recess and percretism findings were evaluated. While pathology and clinical intrapartum findings constituted the reference standard for placenta accreta spectrum (PAS), intrapartum/peripartum bleeding over 1000 mL and emergency hyst erectomy were regarded as poor clinical outcomes. The values of MRI fi ndings in predicting both PAS and clinical outcomes were analyzed. Results: Age, (platelet) PLT value and gestational age were similar in patients with both groups. Signs of percretism had the best diagnostic test performance in pr edicting clinical worsening, followed by intraplacental abnormal vascularization and placental recession (respectively 80.6%, 76.4%, 73.6%) . The most valuable finding in predicting PAS was percretism sign, placental recess, and myometrial thinning (respectively 85.0%, 81.3%, 79.4%). Conclusion: Percretism and intraplacental abnormal vascularization are highly predictive of a possible poor clinical outcome.

Anahtar Kelime:

Plasenta Previa Olgularında Plasenta Akreta Spektrumunu (PAS) ve Klinik Sonuçları Tahmin Etmede Prenatal MRG'nin Tanısal Doğruluğunun Değerlendirilmesi

Öz:

Amaç: Bu çalışmanın amac ı, manyetik rezonans görüntüleme (MRG) parametrelerinin plasenta akreta spektrumunu (PAS) ve plasenta previal ı hastaların klinik sonuçlarını öngörmedeki değerini araştırmaktır. Gereç ve Yöntem: 1.5 ve 3 Tesla taray ıcı ile alınan toplam 56 prenatal plasenta MRG tetkiki 2 radyolog tarafından mutabakatla retrospektif olarak incelendi. T2 koyu bant varlığı, myometriumda incelme, anormal vaskülarizasyon, uterin bombeleşme, heterojen plasenta, plasenta protrüzyonu, plasenta reses ve perkretizm bulguları değerlendirildi. Plasenta akreta spektrumu (PAS) için patoloji ve klinik intrapartum bulgular referans standardı oluştururken, 1000 mL'nin üzerinde intrapartum/peripartum kanama ve acil histerektomi kötü klinik sonuçlar olarak kabul edildi. MRG bulgularının hem PAS'ı hem de klinik sonuçları öngörmedeki değerleri analiz edildi. Bulgular: Klinik sonuçları iyi ve kötü olan hastalar arasında yaş, platelet (PLT) de ğeri ve gebelik süresi açısından anlamlı fark yoktu. Klinik kötüleşmeyi öngörmede perkretizm belirtileri en iyi tanısal test performansına sahipti, ardından intraplasental anormal vaskülarizasyon ve plasental gerileme geldi (sırasıyla respectively 80.6%, 76.4%, 73.6%). PAS'ı öngörmede en de ğerli bulgu perkretizm işareti, plasental reses ve miyometriyal incelme idi (sırasıyla 85.0%, 81.3%, 79.4%). Sonuç: perkretizm ve intraplasental anormal vaskülarizasyon olası bir kötü klinik sonucun yüksek oranda göstergesidir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Akkaya H, İzgi N, TAS Z, Gulek B (2023). Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa. , 133 - 141.
Chicago	Akkaya Hüseyin,İzgi Nedim,TAS Zeynel Abidin,Gulek Bozkurt Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa. (2023): 133 - 141.
MLA	Akkaya Hüseyin,İzgi Nedim,TAS Zeynel Abidin,Gulek Bozkurt Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa. , 2023, ss.133 - 141.
AMA	Akkaya H,İzgi N,TAS Z,Gulek B Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa. . 2023; 133 - 141.
Vancouver	Akkaya H,İzgi N,TAS Z,Gulek B Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa. . 2023; 133 - 141.
IEEE	Akkaya H,İzgi N,TAS Z,Gulek B "Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa." , ss.133 - 141, 2023.
ISNAD	Akkaya, Hüseyin vd. "Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa". (2023), 133-141.

APA	Akkaya H, İzgi N, TAS Z, Gulek B (2023). Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa. Van Tıp Dergisi, 30(2), 133 - 141.
Chicago	Akkaya Hüseyin,İzgi Nedim,TAS Zeynel Abidin,Gulek Bozkurt Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa. Van Tıp Dergisi 30, no.2 (2023): 133 - 141.
MLA	Akkaya Hüseyin,İzgi Nedim,TAS Zeynel Abidin,Gulek Bozkurt Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa. Van Tıp Dergisi, vol.30, no.2, 2023, ss.133 - 141.
AMA	Akkaya H,İzgi N,TAS Z,Gulek B Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa. Van Tıp Dergisi. 2023; 30(2): 133 - 141.
Vancouver	Akkaya H,İzgi N,TAS Z,Gulek B Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa. Van Tıp Dergisi. 2023; 30(2): 133 - 141.
IEEE	Akkaya H,İzgi N,TAS Z,Gulek B "Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa." Van Tıp Dergisi, 30, ss.133 - 141, 2023.
ISNAD	Akkaya, Hüseyin vd. "Evaluation of the Diagnostic Accuracy of Prenatal MRI in Predicting Placenta Accreta Spectrum (PAS) and Clinical Outcomes in Cases with Placenta Previa". Van Tıp Dergisi 30/2 (2023), 133-141.