Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
Eur Radiol. 2021 Feb;31(2):740-748. doi: 10.1007/s00330-020-07200-1. Epub 2020 Aug 30.
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).
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.
The f and D* values for the AP-ROIs ([45.0 ± 7.63]%, [11.64 ± 2.15]mm/s) were significantly higher than those for the NP-ROIs ([31.85 ± 5.96]%, [9.04 ± 3.13]mm/s) (both p < 0.05); the IR-ROIs (54.8%, 14.03 mm/s) were also significantly higher than the NIR-ROIs (37.4%, 11.4 mm/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.
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.
• 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.
通过对比胎盘植入病灶（AP）与正常胎盘（NP）的弥散和灌注特征，探讨体素内不相干运动（IVIM）DWI 对胎盘植入的诊断价值。
25 例 AP 孕妇和 24 例 NP 孕妇均接受了 3-T 磁共振 IVIM-DWI 检查。从不同 ROI 计算灌注百分比（f）、假性扩散系数（D*）和扩散系数（D）值：AP 全平面 ROI（AP-ROI）和 NP-ROI（NP-ROI）以及 AP 的植入区（IR-ROI）和非植入区（NIR-ROI）。使用协方差分析比较 AP-ROI 和 NP-ROI；使用 Wilcoxon 符号秩检验比较 IR-ROI 和 NIR-ROI。绘制 ROC 曲线以评估参数预测胎盘植入的能力。
AP-ROI 的 f 和 D值[45.0±7.63]%、[11.64±2.15]mm/s明显高于 NP-ROI 的 f 和 D值[31.85±5.96]%、[9.04±3.13]mm/s（均 p＜0.05）；IR-ROI（54.8%、14.03mm/s）也明显高于 NIR-ROI（37.4%、11.4mm/s）（均 p＜0.05）。AP-ROI 和 NP-ROI 的 D 值（p＞0.05）或 IR-ROI 和 NIR-ROI 的 D 值（p＞0.05）之间无显著差异。ROC 曲线的 f 和 D*曲线下面积分别为 0.93 和 0.79。
这些结果表明，IVIM 参数 f 和 D*可用于定量评估 AP 与 NP 相比具有更高的灌注。此外，IVIM 可能是一种有用的功能诊断技术，可用于预测胎盘植入。
体素内不相干运动（IVIM）可能是一种有用的诊断技术，可用于定量估计胎盘的灌注。
胎盘植入病灶与正常胎盘之间的灌注百分比（f）和假性扩散系数（D*）值有显著差异。
ROC 曲线显示，灌注百分比（f）和假性扩散系数（D*）值可准确预测胎盘植入。
