Diffusion and perfusion MRI parameters in the evaluation of placenta accreta spectrum disorders in patients with placenta previa

MAGMA. 2022 Dec;35(6):1009-1020. doi: 10.1007/s10334-022-01023-5. Epub 2022 Jul 8.

Abstract

Objectives: To evaluate the placental function by monoexponential, biexponential, and diffusion kurtosis MR imaging (MRI) in patients with placenta previa.

Methods: A total of 62 patients with placenta accreta spectrum (PAS) disorders and 11 patients with normal placentas were retrospectively enrolled, who underwent conventional diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM), and diffusion kurtosis imaging (DKI). The apparent diffusion coefficient (ADC) and exponential ADC (eADC) from standard DWI, mean kurtosis (MK), and diffusion coefficient (MD) from DKI, and pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) from IVIM were measured and compared from the volumetric analysis.

Results: Comparisons between patients with PAS disorders and patients with normal placentas demonstrated that MD mean, D mean, and D* mean values in patients with PAS disorders were significantly higher than those in patients with normal placentas (p < 0.05). Comparisons between patients with accreta, increta, and percreta, and patients with normal placentas showed that the D mean was significantly higher in patients with placenta increta and percreta than in patients with normal placentas (p < 0.05).

Conclusion: The accreta lesions in PAS disorders had deceased cellularity and increased blood movement. The alteration of placental cellularity was more prominent in placenta increta and percreta.

Keywords: Diffusion kurtosis imaging; Diffusion-weighted MRI; Intravoxel incoherent motion; Placenta accreta spectrum disorders.

MeSH terms

  • Diffusion Magnetic Resonance Imaging / methods
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Perfusion
  • Placenta / diagnostic imaging
  • Placenta Accreta* / diagnostic imaging
  • Placenta Previa* / diagnostic imaging
  • Pregnancy
  • Retrospective Studies