Prospective comparative analysis for application and selection of FIESTA sequence and SSFSE sequence in MRI for prenatal diagnosis of placenta previa accreta

Abstract

Placenta previa accreta patients were examined using fast-imaging employing steady-state acquisition (FIESTA) and single-shot fast spin echo (SSFSE) sequence. The diagnostic value of the two sequences was compared. FIESTA was better than the SSFSE sequence in displaying outline-boundary (excellent: 82 vs. 26), signal-to-noise ratio (excellent: 75 vs. 54) for placenta and uterus. The direct signs detection rate in FIESTA was higher than SSFSE (implantable: P = .028, adhesive: P = .131, penetrating type: P = .326). The indirect signs detection rate in FIESTA was lower than SSFSE (low-signal density: P = .029, uneven-signal density: P = .328, thicker and more vascular shadow: P = 398). FIESTA combining SSFSE demonstrated higher detecting rates (100% for sensitivity, specificity, and accuracy) for all types than single sequence scanning (FIESTA/SSFSE). In conclusion, FIESTA clearly showed the situation of the placenta and uterus in placenta previa accreta patients, with excellent image quality. A combination of FIESTA and SSFSE can improve the diagnostic value of placenta previa accreta.

Important statement

• What is already known on this subject? Placenta previa is the most common cause of vaginal bleeding in the third trimester of pregnancy.

• What do the results of this study add? FIESTA was better than the SSFSE sequence in displaying images and demonstrated higher detection rates for direct signs and lower detection rate comparing the SSFSE sequence. FIESTA combining SSFSE sequence demonstrated higher detecting rates for implantable, adhesive and penetrating types than single sequence scanning.

• What are the implications of these findings for clinical practice and/or further research? FIESTA sequence clearly showed the situation of placenta and uterus in placenta previa accreta patients, with excellent image quality. Combination of FIESTA and SSFSE sequences can effectively improve the diagnostic value of placenta previa accreta.

Keywords:

• Placenta previa accreta
• FIESTA
• SSFSE
• MRI
• diagnosis

Ethical approval

This study was approved by the Ethical Committee of Foshan Women and Children Hospital Affiliated with Southern Medical University. The patients have approved and provided the writing form consent.

Disclosure statement

Authors state explicitly that there are no conflicts of interest in connection with this article. All authors declare independence from any funding agency for this work.