AI Article Synopsis
- The study focuses on placenta previa complicated by placenta accrete spectrum (PAS), emphasizing the need for preoperative diagnosis to ensure proper management of this serious condition.
- Researchers analyzed MRI images from 145 patients to identify 11 features related to PAS, finding eight features significantly correlated with the condition, particularly placental/uterine bulge and myometrial thinning.
- A decision tree model, based on five key MRI features, was developed and demonstrated high sensitivity (90%) and specificity (95.5%) for predicting PAS in patients diagnosed with placenta previa.
Article Abstract
Purpose: Placenta previa complicated by placenta accrete spectrum (PAS) is a life-threatening obstetrical condition; therefore, preoperative diagnosis of PAS is important to determine adequate management. Although several MRI features that suggest PAS has been reported, the diagnostic importance, as well as optimal use of each feature has not been fully evaluated.
Materials And Methods: The occurrence of 11 PAS-related MRI features was investigated in MR images of 145 patients with placenta previa. The correlation between each MRI feature and pathological diagnosis of PAS was evaluated using univariate analysis. A decision tree model was constructed according to a random forest machine learning model of variable selection.
Results: Eight MRI features showed a significant correlation with PAS in univariate analysis. Among these features, placental/uterine bulge and myometrial thinning showed high odds ratios: 138.2 (95% CI: 12.7-1425.6) and 66.0 (95% CI: 18.01-237.1), respectively. A decision tree was constructed based on five selected MRI features: myometrial thinning, placental bulge, serosal hypervascularity, placental ischemic infarction/recess, and intraplacental T2 dark bands. The decision tree predicted the presence of PAS in the randomly assigned validation cohort with significance (p < 0.001). The sensitivity and the specificity of the decision tree for detecting PAS were 90.0% (95%CI: 53.2-98.9) and 95.5% (95%CI: 89.9-96.8), respectively.
Conclusion: Among PAS-related MRI features, placental/uterine bulge and myometrial thinning showed high diagnostic values. In addition, the present decision tree model was shown to be effective in predicting the presence of PAS in cases with placenta previa.
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| http://dx.doi.org/10.1007/s11604-024-01684-3 | DOI Listing |
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