Functional diagnosis of placenta accreta by intravoxel incoherent motion model diffusion-weighted imaging

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...

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Veröffentlicht in:European radiology 2021-02, Vol.31 (2), p.740-748
Hauptverfasser: Bao, Yuwei, Pang, Ying, Sun, Ziyan, Li, Qian, Tang, Dazhong, Xia, Liming
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Pang, Ying
Sun, Ziyan
Li, Qian
Tang, Dazhong
Xia, Liming
description 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 IVIM-DWI. 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 (NIR-ROI) 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]mm 2 /s) were significantly higher than those for the NP-ROIs ([31.85 ± 5.96]%, [9.04 ± 3.13]mm 2 /s) (both p < 0.05); the IR-ROIs (54.8%, 14.03 mm 2 /s) were also significantly higher than the NIR-ROIs (37.4%, 11.4 mm 2 /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.
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Methods Twenty-five pregnant women with AP and 24 with NP underwent 3-T magnetic resonance examinations with IVIM-DWI. 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 (NIR-ROI) 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]mm 2 /s) were significantly higher than those for the NP-ROIs ([31.85 ± 5.96]%, [9.04 ± 3.13]mm 2 /s) (both p &lt; 0.05); the IR-ROIs (54.8%, 14.03 mm 2 /s) were also significantly higher than the NIR-ROIs (37.4%, 11.4 mm 2 /s) (both p &lt; 0.05). No significant differences were found between the D values of the AP-ROIs and NP-ROIs ( p &gt; 0.05) or of the IR-ROIs and NIR-ROIs ( p &gt; 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.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-020-07200-1</identifier><identifier>PMID: 32862290</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Covariance ; Diagnostic Radiology ; Diagnostic systems ; Diffusion ; Diffusion coefficient ; Diffusion Magnetic Resonance Imaging ; Evaluation ; Female ; Humans ; Imaging ; Infrared analysis ; Internal Medicine ; Interventional Radiology ; Lesions ; Magnetic Resonance ; Medical diagnosis ; Medicine ; Medicine &amp; Public Health ; Motion ; Neuroradiology ; Parameters ; Perfusion ; Placenta ; Placenta Accreta - diagnostic imaging ; Pregnancy ; Radiology ; Rank tests ; ROC Curve ; Ultrasound</subject><ispartof>European radiology, 2021-02, Vol.31 (2), p.740-748</ispartof><rights>European Society of Radiology 2020</rights><rights>European Society of Radiology 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-249a408fbb93f1cb845837c72026a5f91f291f4180aceaded3a867472b128bd33</citedby><cites>FETCH-LOGICAL-c375t-249a408fbb93f1cb845837c72026a5f91f291f4180aceaded3a867472b128bd33</cites><orcidid>0000-0001-8481-3380</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-020-07200-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-020-07200-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32862290$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bao, Yuwei</creatorcontrib><creatorcontrib>Pang, Ying</creatorcontrib><creatorcontrib>Sun, Ziyan</creatorcontrib><creatorcontrib>Li, Qian</creatorcontrib><creatorcontrib>Tang, Dazhong</creatorcontrib><creatorcontrib>Xia, Liming</creatorcontrib><title>Functional diagnosis of placenta accreta by intravoxel incoherent motion model diffusion-weighted imaging</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>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 IVIM-DWI. 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 (NIR-ROI) 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]mm 2 /s) were significantly higher than those for the NP-ROIs ([31.85 ± 5.96]%, [9.04 ± 3.13]mm 2 /s) (both p &lt; 0.05); the IR-ROIs (54.8%, 14.03 mm 2 /s) were also significantly higher than the NIR-ROIs (37.4%, 11.4 mm 2 /s) (both p &lt; 0.05). No significant differences were found between the D values of the AP-ROIs and NP-ROIs ( p &gt; 0.05) or of the IR-ROIs and NIR-ROIs ( p &gt; 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.</description><subject>Covariance</subject><subject>Diagnostic Radiology</subject><subject>Diagnostic systems</subject><subject>Diffusion</subject><subject>Diffusion coefficient</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Evaluation</subject><subject>Female</subject><subject>Humans</subject><subject>Imaging</subject><subject>Infrared analysis</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Lesions</subject><subject>Magnetic Resonance</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine &amp; 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Methods Twenty-five pregnant women with AP and 24 with NP underwent 3-T magnetic resonance examinations with IVIM-DWI. 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 (NIR-ROI) 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]mm 2 /s) were significantly higher than those for the NP-ROIs ([31.85 ± 5.96]%, [9.04 ± 3.13]mm 2 /s) (both p &lt; 0.05); the IR-ROIs (54.8%, 14.03 mm 2 /s) were also significantly higher than the NIR-ROIs (37.4%, 11.4 mm 2 /s) (both p &lt; 0.05). No significant differences were found between the D values of the AP-ROIs and NP-ROIs ( p &gt; 0.05) or of the IR-ROIs and NIR-ROIs ( p &gt; 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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32862290</pmid><doi>10.1007/s00330-020-07200-1</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8481-3380</orcidid></addata></record>
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source MEDLINE; SpringerLink Journals - AutoHoldings
subjects Covariance
Diagnostic Radiology
Diagnostic systems
Diffusion
Diffusion coefficient
Diffusion Magnetic Resonance Imaging
Evaluation
Female
Humans
Imaging
Infrared analysis
Internal Medicine
Interventional Radiology
Lesions
Magnetic Resonance
Medical diagnosis
Medicine
Medicine & Public Health
Motion
Neuroradiology
Parameters
Perfusion
Placenta
Placenta Accreta - diagnostic imaging
Pregnancy
Radiology
Rank tests
ROC Curve
Ultrasound
title Functional diagnosis of placenta accreta by intravoxel incoherent motion model diffusion-weighted imaging
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