Magnetic resonance imaging of clinically stable late pregnancy bleeding: beyond ultrasound
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Gabriele Masselli & Roberto Brunelli & Tiziana Parasassi & Giuseppina Perrone & Gianfranco Gualdi
- چاپ و سال / کشور: 2011
Description
Objectives To compare the accuracy of magnetic resonance (MRI) and colour Doppler-ultrasound (US) in the diagnosis of late pregnancy bleeding and to assess the accuracy of the different MR sequences in visualizing the origin of haemorrhage. Methods 42 patients in the third trimester of pregnancy underwent to US and MRI for the evaluation of painless vaginal bleeding. Multiplanar HASTE, True Fisp, 3D T1 GRE and sagittal DWI sequences were acquired. Two radiologists, blinded to the results of US, reviewed each case, resolving by consensus any discrepancy. Reference standards were surgical and pathological findings. Results The reference standards identified 22 placenta previa, 11 placental abruptions (1 coincident with a placental chorioangioma), 1 thrombohaematoma and 1 fibroma with haemorrhagic degeneration. MRI identified correctly all these condition with an interobserver agreement of 0.955. DWI and T1 weighted sequences were statistically superior to Haste and True Fisp sequences in detecting the cause of bleeding (p<.001). US had 6 false negatives and 2 false positive results, its diagnostic accuracy resulting lower than MRI (p=.001). Conclusions MRI accurately evaluates pregnancy bleeding with an excellent interobserver agreement and can grant new and additional data when US is negative.
Eur Radiol (2011) 21:1841–1849 DOI 10.1007/s00330-011-2120-8 Received: 28 December 2010 / Accepted: 23 February 2011 / Published online: 12 April 2011
