{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:45:32Z","timestamp":1790318732342,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002855","name":"MOST","doi-asserted-by":"publisher","award":["2018YFE0114600"],"award-info":[{"award-number":["2018YFE0114600"]}],"id":[{"id":"10.13039\/501100002855","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["61801424"],"award-info":[{"award-number":["61801424"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81971606"],"award-info":[{"award-number":["81971606"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Prenatal diagnosis of placenta accreta spectrum (PAS) disorders is difficult. Magnetic resonance imaging (MRI) has been shown to be a useful supplementary method to ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate diffusion MRI (dMRI) based tractography as a tool for detecting PAS disorders, and to evaluate its performance compared with anatomical MRI.<\/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>Forty\u2010seven pregnant women in the third trimester with risk factors for PAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>Using fast imaging employing steady\u2010state acquisition and high\u2010angular resolution dMRI at 1.5 Tesla.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Diagnosis of PAS was performed by three radiologists based on the dMRI\u2010based feature of myometrial fiber discontinuity and on commonly used anatomical features including presence of dark band, discontinuous myometrium and bladder wall interruption. We evaluated the sensitivity, specificity, accuracy, and area\u2010under\u2010the\u2010curve (AUC) of the individual features and established an integrated model with random forest analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Maternal age and gestational age at scan were compared between PAS and control group using a <jats:italic>t<\/jats:italic>\u2010test, and childbearing history was compared using a chi\u2010squared test. The random forest model was employed to combine the anatomical and dMRI features with 5\u2010fold cross\u2010validation, and the weight of each feature was normalized to evaluate its importance in predicting PAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on surgical pathology reports, 16 out of 47 patients had confirmed PAS. The anatomical feature of dark bands and tractography marker achieved the highest AUC of 0.842 for predicting PAS, and the integrated anatomical and tractography features further improved the AUC of 0.880 with an accuracy of 87.2%. The tractography feature contributed most (30.1%) to the integrated model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Myometrial tractography demonstrated superior performance in detecting PAS. Moreover, the combination of dMRI\u2010based tractography and anatomical MRI could potentially improve the diagnosis of PAS disorders in clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy Stage<\/jats:title><jats:p>2<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.27794","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T03:38:40Z","timestamp":1624333120000},"page":"255-264","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Diffusion <scp>MRI<\/scp> Based Myometrium Tractography for Detection of Placenta Accreta Spectrum Disorder"],"prefix":"10.1002","volume":"55","author":[{"given":"Guohui","family":"Yan","sequence":"first","affiliation":[{"name":"Department of Radiology, Women's Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhao","family":"Liao","sequence":"additional","affiliation":[{"name":"Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering &amp; Instrument Science Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology, Women's Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Women's Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8185-1496","authenticated-orcid":false,"given":"Weizeng","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Radiology, Women's Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8738-1851","authenticated-orcid":false,"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering &amp; Instrument Science Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2922-3334","authenticated-orcid":false,"given":"Yu","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Radiology, Women's Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danqing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Women's Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9303-5821","authenticated-orcid":false,"given":"Dan","family":"Wu","sequence":"additional","affiliation":[{"name":"Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering &amp; Instrument Science Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-019-06617-7"},{"issue":"6","key":"e_1_2_7_3_1","first-page":"1088","article-title":"A study of placenta accreta","volume":"38","author":"Irving C","year":"1937","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13547"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.05.002"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.04.049"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2015.01.014"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0200252"},{"issue":"9","key":"e_1_2_7_9_1","first-page":"799","article-title":"Risk factors for placenta accreta: A large prospective cohort","volume":"31","author":"Bowman ZS","year":"2014","journal-title":"Am J Perinatol"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2013-0199"},{"key":"e_1_2_7_11_1","first-page":"1","article-title":"Placenta accreta spectrum disorder: A comparison between fertility\u2010sparing techniques and hysterectomy","volume":"5","author":"Durukan H","year":"2020","journal-title":"J Obstet Gynaecol"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.287085060"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12407"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.12.037"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13258"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-014-3354-z"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000017908"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.11.006"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2020.117195"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/diseases4030029"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/76693739"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2020.110132"},{"key":"e_1_2_7_23_1","first-page":"192647","article-title":"MRI of skeletal muscles in participants with type 2 diabetes with or without diabetic polyneuropathy","volume":"13","author":"Stouge A","year":"2020","journal-title":"Radiology"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2007.02.016"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2004.07.037"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2019.116137"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmq016"},{"key":"e_1_2_7_28_1","first-page":"1670","article-title":"Improved probabilistic streamlines tractography by 2nd order integration over fibre orientation distributions","volume":"18","author":"Tournier J\u2010D","year":"2010","journal-title":"Proc Int Soc Magn Reson Med"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.5152\/dir.2017.16275"},{"issue":"23","key":"e_1_2_7_30_1","first-page":"18","article-title":"Matthew wiener. Classification and regression by random Forest","volume":"23","author":"Liaw A","year":"2002","journal-title":"R News"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19045"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.10.022"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-019-06372-9"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-018-1599-8"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2017162385"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-07200-1"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/0284185114552293"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6224"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/ar.a.20274"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2018.2798801"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2020.2998600"}],"container-title":["Journal of Magnetic Resonance Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmri.27794","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmri.27794","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmri.27794","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T19:13:40Z","timestamp":1692818020000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmri.27794"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,21]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1002\/jmri.27794"],"URL":"https:\/\/doi.org\/10.1002\/jmri.27794","archive":["Portico"],"relation":{},"ISSN":["1053-1807","1522-2586"],"issn-type":[{"value":"1053-1807","type":"print"},{"value":"1522-2586","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,21]]},"assertion":[{"value":"2021-03-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}