Valor da ressonância magnética no diagnóstico antenatal do acretismo placentário

Detalhes bibliográficos
Autor(a) principal: Francisco, Viviane Vieira [UNIFESP]
Data de Publicação: 2006
Outros Autores: Goldman, Suzan Menasce [UNIFESP], Faria, Juliano [UNIFESP], Szejnfeld, Jacob [UNIFESP]
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.1590/S0100-72032006001200003
http://repositorio.unifesp.br/handle/11600/3374
Resumo: PURPOSE: to establish the main signs of placental accretism in magnetic resonance imaging (MRI) in patients with clinical suspicion and to estimate the benefit of this method. METHODS: prospective transversal study with 15 patients suspected of placental accretism, referred between March 2003 and February 2006. Gestational age varied from 20 to 31 weeks. All patients underwent MRI to study the placenta and had previously done an ultrasonography. Material was sent to histological study. MRI was done on Magnetom Impact and Sonata Maestro Class Siemens®, with acquired sequences HASTE, TURBO SPIN in axial, sagittal, coronal planes and echo gradient (GE®), pre- and post-dynamic contrast in the best plan for acquisition. Images were analyzed by a team of two radiologists. RESULTS: mean gestational age was 24.3 weeks. We studied seven placenta previa (47%), six anterior placentas (40%) and two posterior placentas (13%). Ultrasonography was positive in 80% of the palcentas and MRI in 53%. However, echography had a low concordance with anatomic pathological studies by Kappa test (11%), revealing 75% of sensitivity, 14% of specificity, 50% as positive predictive value (PPV) and 33% as negative predictive value (NPV). MRI had an excellent concordance with anatomic pathological studies (0.86), showing 100% of sensitivity, 86% of specificity, 89% as PPV and 100% as NPV. CONCLUSIONS: MRI is useful for placental accretism diagnosis. The principal findings are transmural hyper-signal, the loss of continuity in myometrial wall in fast sequences and the identification of vessels invading myometrial layer in dynamic sequences.
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spelling Valor da ressonância magnética no diagnóstico antenatal do acretismo placentárioValue of magnetic resonance imaging in prenatal diagnosis of placental accretismPlacenta accretaMagnetic resonance imagingPlacenta acretaImagem por ressonância magnéticaPURPOSE: to establish the main signs of placental accretism in magnetic resonance imaging (MRI) in patients with clinical suspicion and to estimate the benefit of this method. METHODS: prospective transversal study with 15 patients suspected of placental accretism, referred between March 2003 and February 2006. Gestational age varied from 20 to 31 weeks. All patients underwent MRI to study the placenta and had previously done an ultrasonography. Material was sent to histological study. MRI was done on Magnetom Impact and Sonata Maestro Class Siemens®, with acquired sequences HASTE, TURBO SPIN in axial, sagittal, coronal planes and echo gradient (GE®), pre- and post-dynamic contrast in the best plan for acquisition. Images were analyzed by a team of two radiologists. RESULTS: mean gestational age was 24.3 weeks. We studied seven placenta previa (47%), six anterior placentas (40%) and two posterior placentas (13%). Ultrasonography was positive in 80% of the palcentas and MRI in 53%. However, echography had a low concordance with anatomic pathological studies by Kappa test (11%), revealing 75% of sensitivity, 14% of specificity, 50% as positive predictive value (PPV) and 33% as negative predictive value (NPV). MRI had an excellent concordance with anatomic pathological studies (0.86), showing 100% of sensitivity, 86% of specificity, 89% as PPV and 100% as NPV. CONCLUSIONS: MRI is useful for placental accretism diagnosis. The principal findings are transmural hyper-signal, the loss of continuity in myometrial wall in fast sequences and the identification of vessels invading myometrial layer in dynamic sequences.OBJETIVOS: estabelecer os principais sinais de acretismo placentário na ressonância magnética (RM) em gestantes com suspeita clínica e avaliar a utilidade do método. MÉTODOS: estudo prospectivo, transversal em 15 pacientes com suspeita de acretismo placentário. O período compreendido foi de março de 2003 a fevereiro de 2006. A idade gestacional variou de 20 a 31 semanas. Todas as pacientes realizaram RM com estudo dirigido para placenta e haviam sido submetidas à ultra-sonografia (US) prévia ao exame. Todas as peças foram encaminhadas para estudo anátomo-patológico (AP). Os exames foram realizados nos equipamentos Magnetom Impact e Sonata Maestro Class Siemens®, adquiridas as seqüências HASTE, TURBO FISP, nos planos axial, sagital e coronal e gradiente echo (GE®) pré- e pós- contraste dinâmico no melhor plano de aquisição. A análise das imagens foi realizada por dois radiologistas em consenso. RESULTADOS: a idade gestacional média das pacientes foi de 24,3 semanas. Foram estudadas sete placentas prévias centro-totais (47%), seis placentas corporais anteriores (40%) e duas placentas corporais posteriores (13%). A US foi positiva em 80% dos casos e a RM em 53% dos casos. No entanto, a US apresentou concordância fraca com o AP pelo teste de kappa (11%), com sensibilidade de 75%, especificidade de 14%, valor preditivo positivo (VPP) de 50% e valor preditivo negativo (VPN) de 33%. Já a RM teve concordância excelente com o AP (0,86), com sensibilidade de 100%, especificidade de 86% , VPP de 89% e VPN de 100%. CONCLUSÃO: a RM é útil na identificação do acretismo placentário. Os principais sinais na RM do acretismo placentário são: o hipersinal transmural, a descontinuidade da parede miometrial nas seqüências rápidas e a identificação dos vasos invadindo o miométrio nas seqüências dinâmicas.Universidade Federal de São Paulo (UNIFESP) Departamento de Diagnóstico por ImagemUNIFESP, Depto. de Diagnóstico por ImagemSciELOFederação Brasileira das Sociedades de Ginecologia e ObstetríciaUniversidade Federal de São Paulo (UNIFESP)Francisco, Viviane Vieira [UNIFESP]Goldman, Suzan Menasce [UNIFESP]Faria, Juliano [UNIFESP]Szejnfeld, Jacob [UNIFESP]2015-06-14T13:36:33Z2015-06-14T13:36:33Z2006-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion700-707application/pdfhttp://dx.doi.org/10.1590/S0100-72032006001200003Revista Brasileira de Ginecologia e Obstetrícia. Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, v. 28, n. 12, p. 700-707, 2006.10.1590/S0100-72032006001200003S0100-72032006001200003.pdf0100-7203S0100-72032006001200003http://repositorio.unifesp.br/handle/11600/3374porRevista Brasileira de Ginecologia e Obstetríciainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-28T11:54:52Zoai:repositorio.unifesp.br/:11600/3374Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-28T11:54:52Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Valor da ressonância magnética no diagnóstico antenatal do acretismo placentário
Value of magnetic resonance imaging in prenatal diagnosis of placental accretism
title Valor da ressonância magnética no diagnóstico antenatal do acretismo placentário
spellingShingle Valor da ressonância magnética no diagnóstico antenatal do acretismo placentário
Francisco, Viviane Vieira [UNIFESP]
Placenta accreta
Magnetic resonance imaging
Placenta acreta
Imagem por ressonância magnética
title_short Valor da ressonância magnética no diagnóstico antenatal do acretismo placentário
title_full Valor da ressonância magnética no diagnóstico antenatal do acretismo placentário
title_fullStr Valor da ressonância magnética no diagnóstico antenatal do acretismo placentário
title_full_unstemmed Valor da ressonância magnética no diagnóstico antenatal do acretismo placentário
title_sort Valor da ressonância magnética no diagnóstico antenatal do acretismo placentário
author Francisco, Viviane Vieira [UNIFESP]
author_facet Francisco, Viviane Vieira [UNIFESP]
Goldman, Suzan Menasce [UNIFESP]
Faria, Juliano [UNIFESP]
Szejnfeld, Jacob [UNIFESP]
author_role author
author2 Goldman, Suzan Menasce [UNIFESP]
Faria, Juliano [UNIFESP]
Szejnfeld, Jacob [UNIFESP]
author2_role author
author
author
dc.contributor.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Francisco, Viviane Vieira [UNIFESP]
Goldman, Suzan Menasce [UNIFESP]
Faria, Juliano [UNIFESP]
Szejnfeld, Jacob [UNIFESP]
dc.subject.por.fl_str_mv Placenta accreta
Magnetic resonance imaging
Placenta acreta
Imagem por ressonância magnética
topic Placenta accreta
Magnetic resonance imaging
Placenta acreta
Imagem por ressonância magnética
description PURPOSE: to establish the main signs of placental accretism in magnetic resonance imaging (MRI) in patients with clinical suspicion and to estimate the benefit of this method. METHODS: prospective transversal study with 15 patients suspected of placental accretism, referred between March 2003 and February 2006. Gestational age varied from 20 to 31 weeks. All patients underwent MRI to study the placenta and had previously done an ultrasonography. Material was sent to histological study. MRI was done on Magnetom Impact and Sonata Maestro Class Siemens®, with acquired sequences HASTE, TURBO SPIN in axial, sagittal, coronal planes and echo gradient (GE®), pre- and post-dynamic contrast in the best plan for acquisition. Images were analyzed by a team of two radiologists. RESULTS: mean gestational age was 24.3 weeks. We studied seven placenta previa (47%), six anterior placentas (40%) and two posterior placentas (13%). Ultrasonography was positive in 80% of the palcentas and MRI in 53%. However, echography had a low concordance with anatomic pathological studies by Kappa test (11%), revealing 75% of sensitivity, 14% of specificity, 50% as positive predictive value (PPV) and 33% as negative predictive value (NPV). MRI had an excellent concordance with anatomic pathological studies (0.86), showing 100% of sensitivity, 86% of specificity, 89% as PPV and 100% as NPV. CONCLUSIONS: MRI is useful for placental accretism diagnosis. The principal findings are transmural hyper-signal, the loss of continuity in myometrial wall in fast sequences and the identification of vessels invading myometrial layer in dynamic sequences.
publishDate 2006
dc.date.none.fl_str_mv 2006-12-01
2015-06-14T13:36:33Z
2015-06-14T13:36:33Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1590/S0100-72032006001200003
Revista Brasileira de Ginecologia e Obstetrícia. Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, v. 28, n. 12, p. 700-707, 2006.
10.1590/S0100-72032006001200003
S0100-72032006001200003.pdf
0100-7203
S0100-72032006001200003
http://repositorio.unifesp.br/handle/11600/3374
url http://dx.doi.org/10.1590/S0100-72032006001200003
http://repositorio.unifesp.br/handle/11600/3374
identifier_str_mv Revista Brasileira de Ginecologia e Obstetrícia. Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, v. 28, n. 12, p. 700-707, 2006.
10.1590/S0100-72032006001200003
S0100-72032006001200003.pdf
0100-7203
S0100-72032006001200003
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv Revista Brasileira de Ginecologia e Obstetrícia
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 700-707
application/pdf
dc.publisher.none.fl_str_mv Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
publisher.none.fl_str_mv Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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