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Suspected invasive placenta: evaluation with magnetic resonance imaging

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Abstract

Purpose

To determine the utility of magnetic resonance imaging (MRI) in diagnosing invasive placenta (IP).

Materials and methods

MRI findings in 32 women with suspected IP were evaluated independently by four readers. Interobserver agreement was calculated with kappa (κ) statistics. Associations between MRI findings and IP were assessed by univariate and multivariate analyses. Sensitivity, specificity and accuracy of MRI for the diagnosis of IP were estimated.

Results

Sixteen women (16/32; 50 %) had confirmed IP. Interobserver correlation for the diagnosis of IP was fair (κ = 0.40). Univariate analysis revealed that thinning or focal defect of the uteroplacental interface (P < 0.0001) was the most discriminating MRI variable in the differentiation between normal and IP. Overall sensitivity and specificity of MRI for the diagnosis of IP were 84 % [95 % CI: 75–94 %] and 80 % [95 % CI: 66–93 %], respectively. Thinning or focal defect of the uteroplacental interface was the most accurate finding (88 %) in the diagnosis of IP. Multivariate analysis revealed that thinning or focal defect of the uteroplacental interface was the single independent predictor of IP (P = 0.0006; OR = 64.99).

Conclusion

MR imaging has 84 % sensitivity [95 % CI: 75–94 %] and 80 % specificity [95 % CI: 66–93 %] for the diagnosis of IP. Thinning or focal defect of the uteroplacental interface is the most discriminating independent MR variable in differentiating between normal placenta and IP.

Key points

• MR imaging has acceptable degrees of accuracy to diagnose invasive placenta.

• Focal uteroplacental interface defect is the best finding to diagnose invasive placenta.

• Focal uteroplacental interface defect is the single independent predictor of invasive placenta.

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Acknowledgements

The scientific guarantor of this publication is Philippe Soyer, MD, PhD. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was obtained from all patients in this study. No subjects or cohorts have been previously reported. Methodology: retrospective, diagnostic study/observational, single centre study.

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Authors and Affiliations

  1. Department of Abdominal and Interventional Imaging, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris cedex 10, France

    Laurence Bour, Vinciane Placé, Sandra Bendavid, Yann Fargeaudou, Delphine Sebbag, Anthony Dohan & Philippe Soyer

  2. Department of Biostatistics and Clinical Research, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris cedex 10, France

    Jean-Jacques Portal & Eric Vicaut

  3. Department of Obstetrics and Gynecology, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris cedex 10, France

    Aude Ricbourg

  4. Diderot-Paris 7 University-Sorbonne Paris-Cité, 10 Avenue de Verdun, 75010, Paris, France

    Delphine Sebbag, Anthony Dohan, Eric Vicaut & Philippe Soyer

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  1. Laurence Bour
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  2. Vinciane Placé
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Correspondence to Philippe Soyer.

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Bour, L., Placé, V., Bendavid, S. et al. Suspected invasive placenta: evaluation with magnetic resonance imaging. Eur Radiol 24, 3150–3160 (2014). https://doi.org/10.1007/s00330-014-3354-z

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  • DOI: https://doi.org/10.1007/s00330-014-3354-z

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