High prevalence of intrapelvic parasitic arteries in patients with placenta accreta spectrum: A case-control study using unenhanced magnetic resonance angiography

To compare the prevalence of enlarged ovarian and intrapelvic parasitic arteries to the gravid uterus between cases of placenta accreta spectrum (PAS) and those with normal placentation using unenhanced magnetic resonance (MR) angiography. Unenhanced time-of-flight MR angiography was performed in 12...

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Bibliographic Details
Published in:Clinical imaging 2020-07, Vol.63, p.50-56
Main Authors: Mori, Kensaku, Saida, Tsukasa, Hoshiai, Sodai, Shibuya, Yoko, Obata-Yasuoka, Mana, Ishiguro, Toshitaka, Takahashi, Hiroaki, Hamada, Hiromi, Sato, Toyomi, Minami, Manabu
Format: Article
Language:English
Subjects:
Age
Angiography
Arteries
Arteriography
Cesarean hysterectomy
Cesarean section
Consent
Embolization
Expansion
Gravid uterus
Hypotheses
Hysterectomy
Magnetic resonance
Magnetic resonance angiography
Medical imaging
Ovarian artery
Ovaries
Parasitic artery
Placenta
Placenta accreta spectrum
Pregnancy complications
Resonance
Statistical tests
Uterus
Veins & arteries
Work stations
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Summary:To compare the prevalence of enlarged ovarian and intrapelvic parasitic arteries to the gravid uterus between cases of placenta accreta spectrum (PAS) and those with normal placentation using unenhanced magnetic resonance (MR) angiography. Unenhanced time-of-flight MR angiography was performed in 12 consecutive women with PAS (mean age, 34 years; range, 23–42 years) and 24 women with normal placentation (mean age, 31 years; range, 24–42 years) in their third trimester and reviewed by two independent observers. The consensus reading served as the reference standard. Findings of pelvic arteriography performed at cesarean hysterectomy were reviewed in all cases of PAS. The prevalence of enlarged ovarian and intrapelvic parasitic arteries was compared using Fisher's exact test. The interobserver agreement was assessed with Kappa statistics. The prevalence of enlarged ovarian arteries was not significantly different between cases of PAS and normal placentation (17% [4/24 pelvic sides] vs. 4% [2/48 pelvic sides], P = .091). The prevalence of intrapelvic parasitic arteries was significantly higher in cases of PAS than in those with normal placentation (67% [16/24 pelvic sides] vs. 0% [0/48 pelvic sides], P 
ISSN:0899-7071
1873-4499
DOI:10.1016/j.clinimag.2020.02.013