{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:42:51Z","timestamp":1788536571368,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,21]],"date-time":"2018-12-21T00:00:00Z","timestamp":1545350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Placenta accreta spectrum (PAS) disorders may be associated with significant mortality and morbidity for both mother and fetus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose\/Hypothesis<\/jats:title><jats:p>To identify MRI risk factors for poor peripartum outcome in gravid patients at risk for PAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>One hundred gravid women (mean age: 34.9 years) at third trimester, with placenta previa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>T<jats:sub>2<\/jats:sub>\u2010SSTSE (single\u2010shot turbo spin echo), T<jats:sub>2<\/jats:sub>\u2010TSE, T<jats:sub>1<\/jats:sub>\u2010TSEFS (TSE images with fat\u2010suppression) at 1.5T.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Fifteen MRI features considered indicative of PAS were recorded by three radiologists and were tested for any association with the following adverse peripartum maternal and neonatal events: increased operation time, profound blood loss, hysterectomy, bladder repair, ICU admission, prematurity, low birthweight, and 5\u2010minute APGAR score &lt;7.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Kappa (K) coefficients were computed as a measure of agreement between intraoperative information\/histology and MRI results as well as for interobserver agreement; chi\u2010square and Fisher's exact tests were used to explore the association of the MRI signs with clinical complications. A score was calculated by adding all recorded MRI signs and its predictive ability was tested using receiver operating characteristic (ROC) analysis, against all complications, separately; odds ratios (ORs) for optimal cutoffs were determined with logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was excellent agreement (K &gt;0.75, <jats:italic>P<\/jats:italic> &lt; 0.001) between MRI and intraoperative findings for invasive placenta, bladder and parametrial involvement. Intraplacental T<jats:sub>2<\/jats:sub> dark bands, myometrial disruption, uterine bulge, and hypervascularity at the utero\u2010placental interface or parametrium, showed significant association (<jats:italic>P<\/jats:italic> &lt; 0.005) with poor clinical outcome for both mother and fetus. The MRI score showed significant predictive ability for each adverse maternal event (area under the curve [AUC]: 0.85\u20130.97, <jats:italic>P<\/jats:italic> &lt; 0.001). The presence of \u22653 MRI signs was the cutoff point for a complicated delivery (OR: 19.08, 95% confidence interval [CI]: 6.05\u201360.13) and \u22656 MRI signs was the cutoff point for massive bleeding (OR: 90.93, 95% CI: 11.3\u2013729.23), hysterectomy (OR: 72.5, 95% CI: 17.9\u2013293.7), or extensive bladder repair (OR: 58.74, 95% CI: 7.35\u2013469.32). The MRI score was not significant for predicting adverse neonatal events including preterm delivery (<jats:italic>P<\/jats:italic>\u2009=\u20090.558), low birthweight (<jats:italic>P<\/jats:italic>\u2009=\u20090.097), and 5\u2010minute Apgar score (<jats:italic>P<\/jats:italic>\u2009=\u20090.078).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Preoperative identification of specific MRI features may predict peripartum course in high\u2010risk patients for PAS.<\/jats:p><jats:p><jats:bold>Level of Evidence<\/jats:bold>: 1<\/jats:p><jats:p><jats:bold>Technical Efficacy<\/jats:bold>: Stage 5<\/jats:p><jats:p>J. Magn. Reson. Imaging 2019;50:602\u2013618.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.26592","type":"journal-article","created":{"date-parts":[[2018,12,22]],"date-time":"2018-12-22T05:28:20Z","timestamp":1545456500000},"page":"602-618","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["MRI prognosticators for adverse maternal and neonatal clinical outcome in patients at high risk for placenta accreta spectrum (PAS) disorders"],"prefix":"10.1002","volume":"50","author":[{"given":"Charis","family":"Bourgioti","sequence":"first","affiliation":[{"name":"Department of Radiology School of Medicine, National and Kapodistrian University of Athens, Aretaieion Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantina","family":"Zafeiropoulou","sequence":"additional","affiliation":[{"name":"Department of Radiology School of Medicine, National and Kapodistrian University of Athens, Aretaieion Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavros","family":"Fotopoulos","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics IASO Maternity Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Evangelia","family":"Nikolaidou","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics IASO Maternity Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Theodora","sequence":"additional","affiliation":[{"name":"Department of Fetal and Maternal Medicine, First Department of Gynaecology and Obstetrics National and Kapodistrian University of Athens, Alexandra Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Daskalakis","sequence":"additional","affiliation":[{"name":"Department of Fetal and Maternal Medicine, First Department of 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