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Placental recess accompanied by a T2 dark band: a new finding for diagnosing placental invasion

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Abstract

Purpose

Our aim was to assess the usefulness of a new magnetic resonance imaging (MRI) finding, the placental recess, for diagnosing placental invasion.

Methods

This retrospective study included 51 patients (mean age 34.1 years, range 26–43 years) with suspected placental invasion who underwent cesarean section. Preoperative MRI was performed using a 1.5-T unit and included axial, sagittal, and coronal T2-weighted imaging (T2WI) with half-Fourier fast spin-echo sequences. Overall, 9 patients showed placental invasion, and 42 did not. Placental recess was defined as a placental deformity with contraction of the placental surface and outer rim of the uterus accompanied by a T2 dark band. Two radiologists independently assessed the presence of the placental recess and conventional findings including uterine bulging, abnormal placental vascularity, placental heterogeneous intensity on T2-weighted imaging (T2WI), and the T2 dark band. Fisher’s two-sided exact test was used to compare findings between patients with and without placental invasion. Interobserver reliability was assessed using the kappa statistic.

Results

MRI features had interobserver reliability of >0.40. Placental recess yielded the highest kappa value (0.898). Significant differences were identified between patients with and without placental invasion regarding abnormal placental vascularity, placental heterogeneous intensity, a T2 dark band, and the placental recess on T2WI (p = 0.0282, 0.0003, 0.0003, <0.0001, respectively). The placental recess had sensitivity, specificity, positive and negative predictive values, and accuracy of 56, 100, 100, 91, and 92%, respectively.

Conclusion

The placental recess was useful for diagnosing placental invasion, with high interobserver variability and accuracy.

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Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima, Fukushima, 960-1295, Japan

    Tomomi Sato, Osamu Hasegawa, Takeshi Shigihara & Fumio Shishido

  2. Department of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan

    Naoko Mori

  3. Department of Obstetrics and Gynecology, Fukushima Medical University, 1 Hikariga-oka, Fukushima, Fukushima, 960-1295, Japan

    Keiya Fujimori

  4. Department of Diagnostic Pathology, Fukushima Medical University, 1 Hikariga-oka, Fukushima, Fukushima, 960-1295, Japan

    Kazuhiro Tasaki

Authors
  1. Tomomi Sato
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  2. Naoko Mori
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  3. Osamu Hasegawa
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  4. Takeshi Shigihara
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  5. Keiya Fujimori
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  6. Kazuhiro Tasaki
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  7. Fumio Shishido
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Corresponding author

Correspondence to Tomomi Sato.

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Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The local institutional review board approved this retrospective study, and informed consent was waived.

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Sato, T., Mori, N., Hasegawa, O. et al. Placental recess accompanied by a T2 dark band: a new finding for diagnosing placental invasion. Abdom Radiol 42, 2146–2153 (2017). https://doi.org/10.1007/s00261-017-1100-0

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  • DOI: https://doi.org/10.1007/s00261-017-1100-0

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