T2-weighted balanced steady-state free procession MRI evaluated for diagnosing placental adhesion disorder in late pregnancy

• DOI: 10.1007/s00330-018-5388-0
• Publication Date: 2018-04-12T07:52:03Z
• Authors: Ang Yang; Xue Hong Xiao; Zhi Long Wang; Ze Yan Wang; Ke Yi Wang
• Keywords: Adult; Placenta Diseases; Placenta; Pregnancy Trimester, Third; Reproducibility of Results; Magnetic Resonance Imaging; 03 medical and health sciences; 0302 clinical medicine; ROC Curve; Pregnancy; Humans; Female; Prospective Studies

This study evaluated the imaging characteristics and accuracy of T2-weighted (T2W) balanced steady-state free procession (b-SSFP) magnetic resonance imaging, relative to b-SSFP or single-shot fast spin echo (SSFSE), for the diagnosis of placental adhesion disorder (PAD).Fifty-one pregnant patients suspected of PAD were examined with T2W b-SSFP, b-SSFP and SSFSE. The image types were independently analysed for signs of PAD: abnormal placental bulge (APB), dark intraplacental bands (DIB), placental heterogeneity (PH) and placental protrusion into adjacent structures (PPAS). The sequences were compared for muscle-to-placenta signal ratio, signs of PAD and area under the receiver operating characteristic curve (AUC) for diagnostic accuracy of PAD.PAD was confirmed in 34 women. The muscle-to-placenta signal ratio was highest in the T2W b-SSFP. The diagnostic rates of APB in T2W b-SSFP were comparable to that of b-SSFP, but were significantly higher than that of SSFSE. The rates of PH in SSFE were comparable to that of b-SSFP, but both were significantly lower than that of T2W b-SSFP. The rates of DIB were significantly higher in T2W b-SSFP images compared with SSFSE. Rates of PPAS were comparable among three sequences. The AUCs of the T2W b-SSFP, b-SSFP and SSFSE were 0.966, 0.890 and 0.823, respectively.T2W b-SSFP has high diagnostic accuracy for PAD relative to SSFSE or b-SSFP, which may be due to its high SNR, T2-weighting and lack of blur.• Signal myometrium-to-placenta ratio was highest in the T2W b-SSFP images. • Diagnostic rate of APB in T2W b-SSFP was highest. • Diagnostic rate of DIB was higher in T2W b-SSFP than in SSFSE. • Diagnostic rate of PH in T2W b-SSFP was highest. • Maximum AUC for diagnostic accuracy of PAD was in T2W b-SSFP.