Department of Radiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, 32 West Second Section, First Ring Road, Chengdu, 610072, China.
Siemens Healthineer, No.278, Zhouzhu Road, Pudong New Area District, Shanghai, 201318, China.
BMC Pregnancy Childbirth. 2022 Apr 22;22(1):349. doi: 10.1186/s12884-022-04644-9.
To investigate the diagnostic value of monoexponential, biexponential, and diffusion kurtosis MR imaging (MRI) in differentiating placenta accreta spectrum (PAS) disorders.
A total of 65 patients with PAS disorders and 27 patients with normal placentas undergoing conventional DWI, IVIM, and DKI were retrospectively reviewed. The mean, minimum, and maximum parameters including the apparent diffusion coefficient (ADC) and exponential ADC (eADC) from standard DWI, diffusion kurtosis (MK), and mean diffusion coefficient (MD) from DKI and pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) from IVIM were measured from the volumetric analysis and compared between patients with PAS disorders and patients with normal placentas. Univariate and multivariated logistic regression analyses were used to evaluate the value of the above parameters for differentiating PAS disorders. Receiver operating characteristics (ROC) curve analyses were used to evaluate the diagnostic efficiency of different diffusion parameters for predicting PAS disorders.
Multivariate analysis demonstrated that only D mean and D max differed significantly among all the studied parameters for differentiating PAS disorders when comparisons between accreta lesions in patients with PAS (AP) and whole placentas in patients with normal placentas (WP-normal) were performed (all p < 0.05). For discriminating PAS disorders, a combined use of these two parameters yielded an AUC of 0.93 with sensitivity, specificity, and accuracy of 83.08, 88.89, and 83.70%, respectively.
The diagnostic performance of the parameters from accreta lesions was better than that of the whole placenta. D mean and D max were associated with PAS disorders.
探讨磁共振成像（MRI）单指数、双指数和扩散峰度成像（DKI）在鉴别胎盘植入谱（PAS）疾病中的诊断价值。
回顾性分析 65 例 PAS 疾病患者和 27 例正常胎盘患者的常规 DWI、IVIM 和 DKI 资料。从容积分析中测量标准 DWI 的平均、最小和最大参数（包括表观扩散系数 ADC 和指数 ADC eADC）、DKI 的扩散峰度 MK 和平均扩散系数 MD 以及 IVIM 的纯扩散系数 D、假性扩散系数 D*和灌注分数 f，并比较 PAS 疾病患者与正常胎盘患者之间的参数。采用单变量和多变量逻辑回归分析评估上述参数鉴别 PAS 疾病的价值。采用受试者工作特征（ROC）曲线分析评估不同扩散参数预测 PAS 疾病的诊断效率。
多变量分析显示，当比较 PAS 患者的植入病变（AP）与正常胎盘患者的整个胎盘（WP-normal）时，只有 D 均值和 D 最大值在所有研究参数中差异有统计学意义（均 p<0.05）。用于鉴别 PAS 疾病时，这两个参数联合使用的 AUC 为 0.93，灵敏度、特异性和准确性分别为 83.08%、88.89%和 83.70%。
与整个胎盘相比，来自植入病变的参数具有更好的诊断性能。D 均值和 D 最大值与 PAS 疾病相关。
