Abdominal Radiology

, Volume 44, Issue 9, pp 3175–3184 | Cite as

Texture analysis of placental MRI: can it aid in the prenatal diagnosis of placenta accreta spectrum?

  • Eric Chen
  • Winnie A. MarEmail author
  • Jeanne M. Horowitz
  • Amanda Allen
  • Priyanka Jha
  • Donald R. Cantrell
  • Kejia Cai



To determine if texture analysis can differentiate placenta accreta spectrum (PAS) from normal placenta on MRI.


We performed retrospective image analysis of 80 patients, comprised of 46 patients with PAS and 34 patients without PAS. Histopathology was used as the reference standard. Sagittal single shot fast spin echo T2-weighted MRI sequences acquired from a single institution were analyzed. Placental heterogeneity was quantified using in-house software on a Matlab platform, including the standard deviation of pixel intensity, coefficient of variation, gray-level co-occurrence matrices (GLCM), histogram-oriented gradients (HOG), and fractal analysis with box sizes from 2 to 512. Two-tailed unpaired Student’s t test was used with statistical significance of p < 0.05.


PAS was associated with higher values for standard deviation of pixel intensity and fractal analysis at every box size. Fractal analysis at box sizes 256 (p = 0.011) and 32 (p = 0.021), and standard deviation of pixel intensity (p = 0.023) were the most statistically significant. Fractal values at box size 256 for PAS was 0.13 versus 0.090 for patients without PAS, while standard deviation of pixel intensity was 3.7 for PAS versus 2.5 for patients without PAS. No statistically significant association between PAS and GLCM, coefficient of variation, and HOG was found.


Statistically significant differences were found between normal and abnormal groups using standard deviation of pixel intensity and fractal analysis.


Placenta accreta spectrum Placenta accreta Texture analysis Fractal analysis MRI 



The authors acknowledge Dr. Kruti P. Maniar, MD for assistance with clarification of pathological criteria in diagnosis of placenta accreta spectrum, and CCTS support for statistical analysis assistance (Grant Number UL1TR002003).

Compliance with ethical statement

Conflict of interest

The authors declare that they have no conflict of interest.

IRB statement

This study was approved by the IRB of the two main test sites, University of Illinois at Chicago and Northwestern.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.College of MedicineUniversity of Illinois at ChicagoChicagoUSA
  2. 2.Department of RadiologyUniversity of Illinois at ChicagoChicagoUSA
  3. 3.Northwestern Memorial HospitalChicagoUSA
  4. 4.Department of RadiologyUniversity of California, San FranciscoSan FranciscoUSA

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