Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, BOX 0628, San Francisco, CA, 94143, USA.
Division of Radiology, School of Medicine, National and Kapodistrian University of Athens, Aretaieion Hospital, Athens, Greece.
Eur Radiol. 2020 May;30(5):2604-2615. doi: 10.1007/s00330-019-06617-7. Epub 2020 Feb 10.
This study was conducted in order to establish the joint Society of Abdominal Radiology (SAR) and European Society of Urogenital Radiology (ESUR) guidelines on placenta accreta spectrum (PAS) disorders and propose strategies to standardize image acquisition, interpretation, and reporting for this condition with MRI.
The published evidence-based data and the opinion of experts were combined using the RAND-UCLA Appropriateness Method and formed the basis for these consensus guidelines. The responses of the experts to questions regarding the details of patient preparation, MRI protocol, image interpretation, and reporting were collected, analyzed, and classified as "recommended" versus "not recommended" (if at least 80% consensus among experts) or uncertain (if less than 80% consensus among experts).
Consensus regarding image acquisition, interpretation, and reporting was determined using the RAND-UCLA Appropriateness Method. The use of a tailored MRI protocol and standardized report was recommended.
A standardized imaging protocol and reporting system ensures recognition of the salient features of PAS disorders. These consensus recommendations should be used as a guide for the evaluation of PAS disorders with MRI.
• MRI is a powerful adjunct to ultrasound and provides valuable information on the topography and depth of placental invasion. • Consensus statement proposed a common lexicon to allow for uniformity in MRI acquisition, interpretation, and reporting of PAS disorders. • Seven MRI features, namely intraplacental dark T2 bands, uterine/placental bulge, loss of low T2 retroplacental line, myometrial thinning/disruption, bladder wall interruption, focal exophytic placental mass, and abnormal vasculature of the placental bed, reached consensus and are categorized as "recommended" for diagnosing PAS disorders.
本研究旨在制定美国腹部放射学会（SAR）和欧洲泌尿生殖放射学会（ESUR）联合胎盘植入谱系（PAS）疾病指南，并提出使用 MRI 规范该疾病图像采集、解读和报告的策略。
使用 RAND-UCLA 适宜性方法结合已发表的循证数据和专家意见，为这些共识指南提供基础。收集并分析专家对患者准备、MRI 方案、图像解读和报告等方面的详细问题的回应，并将其归类为“推荐”或“不推荐”（如果专家中至少有 80%的人达成共识）或“不确定”（如果专家中不到 80%的人达成共识）。
使用 RAND-UCLA 适宜性方法确定了图像采集、解读和报告的共识。推荐使用定制的 MRI 方案和标准化报告。
标准化的成像方案和报告系统可确保 PAS 疾病特征的识别。这些共识建议应作为 MRI 评估 PAS 疾病的指南。
• MRI 是超声的有力辅助手段，可提供有关胎盘植入部位和深度的有价值信息。
• 提出共识声明，以建立 PAS 疾病 MRI 采集、解读和报告的通用词汇。
• 七个 MRI 特征，即胎盘内暗 T2 带、子宫/胎盘膨出、低 T2 子宫后线消失、子宫肌层变薄/中断、膀胱壁中断、局灶性外生胎盘肿块和胎盘床异常血管，达成共识，归类为“推荐”用于诊断 PAS 疾病。
