In-vitro fertilisation–embryo-transfer complicates the antenatal diagnosis of placenta accreta spectrum using MRI: a retrospective analysis. Issue 12 (December 2020)

• Record Type: Journal Article
• Authors: Nagase, Y.; Matsuzaki, S.; Mizuta-Odani, C.; Onishi, H.; Tanaka, H.; Nakagawa, S.; Mimura, K.; Tomimatsu, T.; Endo, M.; Kimura, T.
• Is Part Of: Clinical radiology. Volume 75:Issue 12(2020)
• Page Start: 927
• Page End: 933
• Publication Date: 2020-12
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2020.07.013
• Languages: English
• ISSNs: 0009-9260

Abstract

Abstract : AIM: To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) for the antenatal diagnosis of placenta accreta spectrum (PAS). MATERIALS AND METHODS: Data from 95 patients with placenta previa or low-lying placenta who underwent MRI at Osaka University Hospital for the antenatal diagnosis of PAS between January 2013 and December 2018 were reviewed retrospectively. The antenatal MRI signs suggesting PAS were assessed. Patients were divided into two groups depending on whether they were diagnosed with PAS. Factors that affected PAS diagnosis were identified using multivariate analysis. RESULTS: The diagnostic accuracy of MRI for detecting PAS was as follows: 71.4% sensitivity, 96.4% specificity, and area under the curve (AUC) of 0.839 (95% confidence interval [CI]: 0.73–0.91). The diagnostic accuracy was lower in patients with in-vitro fertilisation with embryo transfer (IVF-ET): 22.2% sensitivity, 93.3% specificity, and AUC=0.578 (95% CI: 0.417–0.724). On multivariate analysis, only IVF-ET showed a significant association with false-positive or -negative MRI diagnosis of PAS (adjusted odds ratio: 26.5; 95% CI: 2.42–289.4; p =0.007). CONCLUSION: IVF-ET affects the antenatal diagnosis of PAS using MRI. Highlights: The number of placenta accreta spectrum (PAS) is increasing. The use of IVF-ET is associated with an increased risk of PAS. The accuracy of MRI for the diagnosis of cases with PAS following IVF-ET was low.