Valor da ressonância magnética no diagnóstico antenatal do acretismo placentário
Autor(a) principal: | |
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Data de Publicação: | 2006 |
Outros Autores: | , , |
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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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 |
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Revista Brasileira de Ginecologia e Obstetrícia |
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info:eu-repo/semantics/openAccess |
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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) |
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UNIFESP |
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UNIFESP |
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Repositório Institucional da UNIFESP |
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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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1814268403419971584 |