Objective:To evaluate the diagnostic accuracy of magnetic resonance imaging(MRI)in diagnosing placenta accreta spectrum(PAS).Methods:We conducted a comprehensive literature search from database inception to November 2...Objective:To evaluate the diagnostic accuracy of magnetic resonance imaging(MRI)in diagnosing placenta accreta spectrum(PAS).Methods:We conducted a comprehensive literature search from database inception to November 2023 using terms such as placenta creta,increta,percreta,PAS,MRI,and their respective Medical Subject Headings terms.All prospective and retro-spective cohort,case-control,and cross-sectional studies involving prenatal magnetic resonance imaging diagnosis of PAS with subsequent pathological confirmation were included.Results:A total of 40 studies encompassing 3664 women met the inclusion criteria,with 1894 cases confirmed pathologically as PAS.The overall sensitivity of MRI was 0.867(95%confidence interval(CI):0.807–0.910),and the specificity was 0.860(95%CI:0.799–0.905),with a correlation of 0.693 between sensitivity and specificity.The estimated odds ratio was 28.693(95%CI:14.463–56.924),the negative likelihood ratio was 0.178(95%CI:0.122–0.258),and the positive likelihood ratio was 4.316(95%CI:3.186–5.846).Analysis of individual MRI criteria revealed estimates of sensitivity,specificity,odds ratio,negative likelihood ratio,and positive likelihood ratio for abnormal placental bed vascularization as 0.500,0.740,2.788,0.571,and 1.645 respectively;0.384,0.985,6.270,0.471,and 2.720 for bladder wall interruption;0.766,0.818,13.638,0.262,and 3.375 for the presence of dark intraplacental bands;0.691,0.913,10.828,0.352,and 3.361 for heterogeneous placenta;0.688,0.984,34.886,0.254,and 7.164 for indistinctive myometrium;0.757,0.864,8.496,0.362,and 2.778 for loss of retroplacental dark zone;0.828,0.593,5.829,0.329,and 1.766 for myometrial thinning;and 0.518,0.916,9.473,0.411,and 3.526 for placental bulge,respectively.Conclusion:MRI demonstrates significant utility in diagnosing PAS and its severity.It is recommended for use in all cases with inconclusive ultrasonographic findings.Registration:Registration number CRD42021267501.展开更多
文摘Objective:To evaluate the diagnostic accuracy of magnetic resonance imaging(MRI)in diagnosing placenta accreta spectrum(PAS).Methods:We conducted a comprehensive literature search from database inception to November 2023 using terms such as placenta creta,increta,percreta,PAS,MRI,and their respective Medical Subject Headings terms.All prospective and retro-spective cohort,case-control,and cross-sectional studies involving prenatal magnetic resonance imaging diagnosis of PAS with subsequent pathological confirmation were included.Results:A total of 40 studies encompassing 3664 women met the inclusion criteria,with 1894 cases confirmed pathologically as PAS.The overall sensitivity of MRI was 0.867(95%confidence interval(CI):0.807–0.910),and the specificity was 0.860(95%CI:0.799–0.905),with a correlation of 0.693 between sensitivity and specificity.The estimated odds ratio was 28.693(95%CI:14.463–56.924),the negative likelihood ratio was 0.178(95%CI:0.122–0.258),and the positive likelihood ratio was 4.316(95%CI:3.186–5.846).Analysis of individual MRI criteria revealed estimates of sensitivity,specificity,odds ratio,negative likelihood ratio,and positive likelihood ratio for abnormal placental bed vascularization as 0.500,0.740,2.788,0.571,and 1.645 respectively;0.384,0.985,6.270,0.471,and 2.720 for bladder wall interruption;0.766,0.818,13.638,0.262,and 3.375 for the presence of dark intraplacental bands;0.691,0.913,10.828,0.352,and 3.361 for heterogeneous placenta;0.688,0.984,34.886,0.254,and 7.164 for indistinctive myometrium;0.757,0.864,8.496,0.362,and 2.778 for loss of retroplacental dark zone;0.828,0.593,5.829,0.329,and 1.766 for myometrial thinning;and 0.518,0.916,9.473,0.411,and 3.526 for placental bulge,respectively.Conclusion:MRI demonstrates significant utility in diagnosing PAS and its severity.It is recommended for use in all cases with inconclusive ultrasonographic findings.Registration:Registration number CRD42021267501.
