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ADC values as a biomarker for placenta accreta spectrum
EP34392
Poster Title: ADC values as a biomarker for placenta accreta spectrum
Submitted on 30 Oct 2020
Author(s): Hiba Alessa, Elspeth Whitby
Affiliations: The University of Sheffield
This poster was presented at BIR Annual Congress 2020
Poster Views: 138
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Poster Information
Abstract: Placenta accreta spectrum (PAS) is an obstetric emergency and a leading cause of life threatening bleeding. Few magnetic resonance imaging (MRI) studies have addressed any significant correlation of PAS features with placental pathology. Identifying invasion signs on MRI, such as heterogeneity and dark bands, are experts’ dependent, and therefore developing an objective approach is warranted. Effective antenatal diagnosis may significantly help in reducing maternal morbidity and mortality.
The aim of this research is to apply MRI apparent diffusion coefficient (ADC) to improve the accuracy of antenatal PAS detection.

Materials and methods: A retrospective review of 153 cases. ADC values were obtained from the area above the bladder and the entire placenta on a midline sagittal image. Heterogeneity of the placenta and placental dark bands were also noted. Pathological diagnosis was obtained from medical records.

Results:
• The mean ADC of invaded placentas were higher than of normal. This was equal to 1400 mm2/second in comparison to 1552 mm2/sec for invaded placentas.

• ADC of a small sampled region in the invaded placenta showed higher accuracy than the whole region of placental ADC. Independent t-test showed a significant correlation of regional ADC and pathology (p= 0.03).

• Regional ADC showed an association with placenta heterogeneity.
• Regional ADC showed an association with dark bands.

Conclusion:
ADC MRI values are a potential marker for future evaluation of PAS to aid confidence in the imaging diagnosis. Further studies are required to assess predictability and reliability.
Summary: Placenta accreta spectrum (PAS) is an obstetric emergency and a leading cause of life threatening bleeding. Few magnetic resonance imaging (MRI) studies have addressed any significant correlation of PAS features with placental pathology. Identifying invasion signs on MRI, such as heterogeneity and dark bands, are experts’ dependent, and therefore developing an objective approach is warranted. Effective antenatal diagnosis may significantly help in reducing maternal morbidity and mortality.References: 1. Maurea S, Romeo V, Mainenti PP, Ginocchio MI, Frauenfelder G, Verde F, et al. Diagnostic accuracy of magnetic resonance imaging in assessing placental adhesion disorder in patients with placenta previa: Correlation with histological findings. Eur J Radiol. 2018;106:77-84.


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