A recent study highlighted specific criteria that less-experienced radiologists should use when diagnosing placental abnormalities on MRI exams.
Placental abnormalities are classified by localization and attachment and must be managed carefully, as they carry the risk of serious complications for women during pregnancy and delivery. Women who have had previous cesareans, other uterine surgery or pathologies, spontaneous abortions, and who are over the age of 35 are all at an increased risk of placental disorders.
“Considering the increasing rate of cesarean section, the growing trend in uterine surgical management, and the higher average age of maternity, the risk of placental insertion anomalies is increasing significantly,” corresponding author Jeries P. Zawaideh, of the Department of Radiology at Addenbrooke’s Hospital and the University of Cambridge, and co-authors explained.
Currently, transvaginal ultrasound is the standard of care for diagnosing placental attachment disorders but recently MRI has emerged as another potential modality that could benefit this demographic of patients. However, studies that have compared the two modalities have had varied results, and the conflicting findings were compounded even more so when the experience level of the radiologist was factored in.
This is what led the experts to conduct their study on the most reliable MRI indicators of placental abnormalities. After choosing 27 placental MRI studies, the researchers recruited six radiologists, all with varying degrees of experience, to interpret them using eight radiological features known to be associated with placental attachment disorders.
By examining the reads from each radiologist, the researchers were able to highlight three features with consistently high sensitivity and specificity: dark bands, myometrial thinning and uterine bulging. When using these three specific features alone, the accuracy of the junior readers increased from 0.74 to 0.93.
“Diagnosis and surgical management remain a specialist field and few centers have significant expertise,” the experts noted. “However, our study demonstrates that even less experienced readers who encounter the need to evaluate placental MRI can obtain a diagnosis with comparable levels of accuracy if they focus on the specific criteria of dark bands, uterine bulging and myometrial thinning, which are easier to identify at all levels of experience.”
You can view the detailed research in the European Journal of Radiology.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.