Ultrasound versus magnetic resonance imaging features in diagnosing placenta accreta: A systematic review and meta-analysis

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-04-10 DOI:10.1016/j.ejrad.2025.112108

Cong Li , Ying Chen , Yang Gao , Yangcan Duan

{"title":"Ultrasound versus magnetic resonance imaging features in diagnosing placenta accreta: A systematic review and meta-analysis","authors":"Cong Li , Ying Chen , Yang Gao , Yangcan Duan","doi":"10.1016/j.ejrad.2025.112108","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study is to conduct a complete analysis of the accuracy of ultrasound and MRI in detecting placenta accreta spectrum (PAS) disorders, as well as to investigate the accuracy of independent imaging findings in these diseases.</div></div><div><h3>Methods</h3><div>Pubmed, Web of Science, Embase, The Cochrane Library, and Google Scholar databases were searched from their establishment to January 1, 2025. Included were all studies that used both ultrasonography and MRI to diagnose pregnant women with PAS disorder. The ability of ultrasonography, MRI, and their independent features to diagnose PAS was evaluated using pooled sensitivity, specificity, diagnostic odds ratio (DOR), and receiver operating curves (ROC). Heterogeneity was calculated using Cochran Q and I<sup>2</sup> statistics, and the sources of heterogeneity were investigated using <em>meta</em>-regression and subgroup analysis.</div></div><div><h3>Results</h3><div>Following a series of rigorous assessments, the <em>meta</em>-analysis comprised 1989 pregnant women from 30 studies. The sensitivity and specificity of ultrasonography for the diagnosis of PAS were 0.87 (95 % CI, 0.82–0.90) and 0.83 (95 % CI, 0.77–0.88), respectively, whereas the sensitivity and specificity of MRI for the same diagnostic were 0.87 (95 % CI, 0.82–0.90) and 0.84 (95 % CI, 0.80–0.88). Intraplacental lacunae has the best diagnostic accuracy of ultrasound, while placental bulge has the highest diagnostic accuracy of MRI, with their area under the curve (AUC) of the ROC being 0.76 (95 % CI, 0.72–0.79) and 0.89 (95 % CI, 0.85–0.91), respectively.</div></div><div><h3>Conclusion</h3><div>The diagnostic accuracy of ultrasound and MRI for PAS was similar. However, radiographic findings should not be utilized to make an independent diagnosis of PAS disorders.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"187 ","pages":"Article 112108"},"PeriodicalIF":3.2000,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0720048X25001949","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

The purpose of this study is to conduct a complete analysis of the accuracy of ultrasound and MRI in detecting placenta accreta spectrum (PAS) disorders, as well as to investigate the accuracy of independent imaging findings in these diseases.

Methods

Pubmed, Web of Science, Embase, The Cochrane Library, and Google Scholar databases were searched from their establishment to January 1, 2025. Included were all studies that used both ultrasonography and MRI to diagnose pregnant women with PAS disorder. The ability of ultrasonography, MRI, and their independent features to diagnose PAS was evaluated using pooled sensitivity, specificity, diagnostic odds ratio (DOR), and receiver operating curves (ROC). Heterogeneity was calculated using Cochran Q and I² statistics, and the sources of heterogeneity were investigated using meta-regression and subgroup analysis.

Results

Following a series of rigorous assessments, the meta-analysis comprised 1989 pregnant women from 30 studies. The sensitivity and specificity of ultrasonography for the diagnosis of PAS were 0.87 (95 % CI, 0.82–0.90) and 0.83 (95 % CI, 0.77–0.88), respectively, whereas the sensitivity and specificity of MRI for the same diagnostic were 0.87 (95 % CI, 0.82–0.90) and 0.84 (95 % CI, 0.80–0.88). Intraplacental lacunae has the best diagnostic accuracy of ultrasound, while placental bulge has the highest diagnostic accuracy of MRI, with their area under the curve (AUC) of the ROC being 0.76 (95 % CI, 0.72–0.79) and 0.89 (95 % CI, 0.85–0.91), respectively.

Conclusion

The diagnostic accuracy of ultrasound and MRI for PAS was similar. However, radiographic findings should not be utilized to make an independent diagnosis of PAS disorders.

查看原文本刊更多论文

超声与磁共振成像特征诊断胎盘增生：系统回顾和荟萃分析

目的全面分析超声和MRI检测胎盘增生谱（PAS）疾病的准确性，并探讨这些疾病独立影像学表现的准确性。方法检索spubmed、Web of Science、Embase、The Cochrane Library和谷歌Scholar数据库自其建立至2025年1月1日的数据。纳入了所有使用超声和MRI诊断孕妇PAS障碍的研究。采用综合敏感性、特异性、诊断优势比（DOR）和受试者工作曲线（ROC）评估超声、MRI及其独立特征诊断PAS的能力。采用Cochran Q和I2统计量计算异质性，并采用meta回归和亚组分析调查异质性的来源。经过一系列严格的评估，荟萃分析包括来自30项研究的1989名孕妇。超声诊断PAS的敏感性和特异性分别为0.87 （95% CI, 0.82-0.90）和0.83 (95% CI, 0.77-0.88)，而MRI诊断PAS的敏感性和特异性分别为0.87 （95% CI, 0.82-0.90）和0.84 （95% CI, 0.80-0.88）。超声诊断胎盘腔隙的准确率最高，MRI诊断胎盘凸起的准确率最高，其ROC曲线下面积（AUC）分别为0.76 （95% CI, 0.72-0.79）和0.89 （95% CI, 0.85-0.91）。结论超声与MRI对PAS的诊断准确率相近。然而，影像学检查结果不应用于PAS疾病的独立诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.