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Society of Abdominal Radiology (SAR) and European Society of Urogenital Radiology (ESUR) joint consensus statement for MR imaging of placenta accreta spectrum disorders
Abstract
Objectives This study was conducted in order to establish the joint Society of Abdominal Radiology (SAR) and European Society of Urogenital Radiology (ESUR) guidelines on placenta accreta spectrum (PAS) disorders and propose strategies to standardize image acquisition, interpretation, and reporting for this condition with MRI.Methods The published evidence-based data and the opinion of experts were combined using the RAND-UCLA Appropriateness Method and formed the basis for these consensus guidelines. The responses of the experts to questions regarding the details of patient preparation, MRI protocol, image interpretation, and reporting were collected, analyzed, and classified as "recommended" versus "not recommended" (if at least 80% consensus among experts) or uncertain (if less than 80% consensus among experts).Results Consensus regarding image acquisition, interpretation, and reporting was determined using the RAND-UCLA Appropriateness Method. The use of a tailored MRI protocol and standardized report was recommended.Conclusions A standardized imaging protocol and reporting system ensures recognition of the salient features of PAS disorders. These consensus recommendations should be used as a guide for the evaluation of PAS disorders with MRI.Key points • MRI is a powerful adjunct to ultrasound and provides valuable information on the topography and depth of placental invasion. • Consensus statement proposed a common lexicon to allow for uniformity in MRI acquisition, interpretation, and reporting of PAS disorders. • Seven MRI features, namely intraplacental dark T2 bands, uterine/placental bulge, loss of low T2 retroplacental line, myometrial thinning/disruption, bladder wall interruption, focal exophytic placental mass, and abnormal vasculature of the placental bed, reached consensus and are categorized as "recommended" for diagnosing PAS disorders.
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“Ultrasound and magnetic resonance imaging (MRI) are the imaging modalities of choice for diagnosing PAS antenatally [5, 6].”
From Radiomics-based prediction of FIGO grade for placenta accreta spectrum (2023) · cites this paper as [5]
In the citing paper
“MRI plays an important role, such as for surgical planning and in the assessment of posterior or lateral defects [5, 7, 8].”
From Radiomics-based prediction of FIGO grade for placenta accreta spectrum (2023) · cites this paper as [5]
In the citing paper
“Well-described MR imaging features, such as abnormal vascularisation of the placental bed and focal exophytic mass, are signs of severe PAS; they are usually seen at the level of the bladder, and are therefore included in the inferior placental ROI [5].”
From Radiomics-based prediction of FIGO grade for placenta accreta spectrum (2023) · cites this paper as [5]
In the citing paper
“there was consensus that there would be limited accuracy in delineating the myometrium which in many cases will be thinned to less than 1 mm or not be visible [5]”
From Radiomics-based prediction of FIGO grade for placenta accreta spectrum (2023) · cites this paper as [5]
In the citing paper
“Ultrasound and MRI both rely heavily on reader expertise of the clinician [5, 10].”
From Radiomics-based prediction of FIGO grade for placenta accreta spectrum (2023) · cites this paper as [5]
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Metadata
- Authors
- Jha, P., Pōder, L., Bourgioti, C., Bharwani, N., Lewis, S., Kamath, A., Nougaret, S., Soyer, P., Weston, M., Castillo, R. P., Kido, A., Forstner, R., & Masselli, G.
- Affiliations
- University of California, San Francisco (US)
- National and Kapodistrian University of Athens (GR)
- Imperial College Healthcare NHS Trust (GB)
- Icahn School of Medicine at Mount Sinai (US)
- Université Paris Cité (FR)
- St James's University Hospital (GB)
- University of Miami (US)
- Kyoto University Hospital (JP)
- Paracelsus Medical University (AT)
- Policlinico Umberto I (IT)
- Corresponding author
- Jha, Priyanka
- ORCID
- Venue
- European Radiology
- Published
- 2020-02-10
- Volume
- 30
- Issue
- 5
- Pages
- 2604-2615
- ISSN
- 0938-7994 (ISSN-L)
- 1432-1084
- OpenAlex
- W3006094000
- Cited by
- 173
- References
- 55
- Citations by year
- 2026: 20 · 2025: 23 · 2024: 34 · 2023: 37 · 2022: 27 · 2021: 21 · 2020: 6
- FWCI
- 21.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Radiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- placenta accreta spectrum, magnetic resonance imaging, placental invasion, standardized imaging protocol, image reporting, myometrial thinning, diagnostic criteria
- MeSH terms
- Female, Humans, Magnetic Resonance Imaging, Placenta, Placenta Accreta, Pregnancy, Radiography, Abdominal, Radiology, Societies, Medical, Consensus
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