MR department of Affiliated Zhongshan City Hospital of Sun Yat-sen University, Sun Wendong Road No. 2, Zhongshan City, Guangdong Province, China.
Eur Radiol. 2018 Sep;28(9):3770-3778. doi: 10.1007/s00330-018-5388-0. Epub 2018 Apr 12.
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.
本研究评估 T2 加权（T2W）平衡稳态自由进动（b-SSFP）磁共振成像相对于 b-SSFP 或单次快速自旋回波（SSFSE）在诊断胎盘粘连障碍（PAD）中的成像特征和准确性。
对 51 例疑似 PAD 的孕妇进行 T2W b-SSFP、b-SSFP 和 SSFSE 检查。独立分析图像类型是否存在 PAD 征象：胎盘异常膨出（APB）、胎盘内暗带（DIB）、胎盘不均匀（PH）和胎盘向邻近结构突出（PPAS）。比较各序列的肌肉与胎盘信号比、PAD 征象和诊断 PAD 准确性的受试者工作特征曲线（ROC）下面积（AUC）。
34 例患者确诊为 PAD。T2W b-SSFP 的肌肉与胎盘信号比最高。T2W b-SSFP 诊断 APB 的诊断率与 b-SSFP 相当，但显著高于 SSFSE。SSFE 中 PH 的诊断率与 b-SSFP 相当，但均显著低于 T2W b-SSFP。T2W b-SSFP 图像中 DIB 的诊断率显著高于 SSFSE。3 种序列中 DIB 的诊断率均显著高于 SSFSE。三种序列的 AUC 分别为 0.966、0.890 和 0.823。
T2W b-SSFP 对 PAD 的诊断准确性高于 SSFSE 或 b-SSFP，这可能与其高 SNR、T2 加权和无模糊有关。
T2W b-SSFP 图像的肌肉与胎盘信号比最高。
T2W b-SSFP 中 APB 的诊断率最高。
T2W b-SSFP 中 DIB 的诊断率高于 SSFSE。
T2W b-SSFP 中 PH 的诊断率最高。
诊断 PAD 准确性的最大 AUC 为 T2W b-SSFP。
