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Horizontal Cervix as a Novel Sign for Predicting Adhesions on the Posterior Extrauterine Wall in Cases of Placenta Previa

We aimed to identify a magnetic resonance imaging (MRI) feature that can predict posterior extrauterine adhesion (posterior adhesion) antenatally, in patients with placenta previa. We retrospectively reviewed patients with placenta previa who underwent a preoperative MRI examination of placenta accr...

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Autores principales: Matsuzaki, Shinya, Okada, Aiko, Endo, Masayuki, Nagase, Yoshikazu, Nakagawa, Satoshi, Hiramatsu, Kosuke, Kakigano, Aiko, Mimura, Kazuya, Takiuchi, Tsuyoshi, Tomimatsu, Takuji, Ueda, Yutaka, Ogita, Kazuhide, Kimura, Tadashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947443/
https://www.ncbi.nlm.nih.gov/pubmed/31817169
http://dx.doi.org/10.3390/jcm8122141
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author Matsuzaki, Shinya
Okada, Aiko
Endo, Masayuki
Nagase, Yoshikazu
Nakagawa, Satoshi
Hiramatsu, Kosuke
Kakigano, Aiko
Mimura, Kazuya
Takiuchi, Tsuyoshi
Tomimatsu, Takuji
Ueda, Yutaka
Ogita, Kazuhide
Kimura, Tadashi
author_facet Matsuzaki, Shinya
Okada, Aiko
Endo, Masayuki
Nagase, Yoshikazu
Nakagawa, Satoshi
Hiramatsu, Kosuke
Kakigano, Aiko
Mimura, Kazuya
Takiuchi, Tsuyoshi
Tomimatsu, Takuji
Ueda, Yutaka
Ogita, Kazuhide
Kimura, Tadashi
author_sort Matsuzaki, Shinya
collection PubMed
description We aimed to identify a magnetic resonance imaging (MRI) feature that can predict posterior extrauterine adhesion (posterior adhesion) antenatally, in patients with placenta previa. We retrospectively reviewed patients with placenta previa who underwent a preoperative MRI examination of placenta accreta spectrum. We categorized the patients into two groups based on whether the cervix was anterior or posterior to a line perpendicular to the anatomical conjugate on the MRI. We projected the perpendicular line toward a straight line through the broad of the back on T2-weighted sagittal MRI images and measured the angle between this line and the line passing through the cervical canal. We analyzed the correlation of the cervical canal angle with the presence of posterior adhesions. Of the 96 patients analyzed, 71 patients had an anteverted cervix and 25 patients had a retroverted cervix. There were 21 posterior adhesions. The adhesion rate was significantly higher in patients with a retroverted cervix than those with an anteverted cervix (8.5% vs. 60%; p = 0.00). The cervical canal angle was ≤10° in 25 patients; of these 17 had adhesions (sensitivity, 81.0%; specificity, 89.3%; area under the curve, 0.887; 95% confidence interval, 0.792–0.981). This finding, labeled “positive horizontal cervix sign,” may be a promising indicator of posterior adhesions in patients with placenta previa.
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spelling pubmed-69474432020-01-13 Horizontal Cervix as a Novel Sign for Predicting Adhesions on the Posterior Extrauterine Wall in Cases of Placenta Previa Matsuzaki, Shinya Okada, Aiko Endo, Masayuki Nagase, Yoshikazu Nakagawa, Satoshi Hiramatsu, Kosuke Kakigano, Aiko Mimura, Kazuya Takiuchi, Tsuyoshi Tomimatsu, Takuji Ueda, Yutaka Ogita, Kazuhide Kimura, Tadashi J Clin Med Article We aimed to identify a magnetic resonance imaging (MRI) feature that can predict posterior extrauterine adhesion (posterior adhesion) antenatally, in patients with placenta previa. We retrospectively reviewed patients with placenta previa who underwent a preoperative MRI examination of placenta accreta spectrum. We categorized the patients into two groups based on whether the cervix was anterior or posterior to a line perpendicular to the anatomical conjugate on the MRI. We projected the perpendicular line toward a straight line through the broad of the back on T2-weighted sagittal MRI images and measured the angle between this line and the line passing through the cervical canal. We analyzed the correlation of the cervical canal angle with the presence of posterior adhesions. Of the 96 patients analyzed, 71 patients had an anteverted cervix and 25 patients had a retroverted cervix. There were 21 posterior adhesions. The adhesion rate was significantly higher in patients with a retroverted cervix than those with an anteverted cervix (8.5% vs. 60%; p = 0.00). The cervical canal angle was ≤10° in 25 patients; of these 17 had adhesions (sensitivity, 81.0%; specificity, 89.3%; area under the curve, 0.887; 95% confidence interval, 0.792–0.981). This finding, labeled “positive horizontal cervix sign,” may be a promising indicator of posterior adhesions in patients with placenta previa. MDPI 2019-12-04 /pmc/articles/PMC6947443/ /pubmed/31817169 http://dx.doi.org/10.3390/jcm8122141 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Matsuzaki, Shinya
Okada, Aiko
Endo, Masayuki
Nagase, Yoshikazu
Nakagawa, Satoshi
Hiramatsu, Kosuke
Kakigano, Aiko
Mimura, Kazuya
Takiuchi, Tsuyoshi
Tomimatsu, Takuji
Ueda, Yutaka
Ogita, Kazuhide
Kimura, Tadashi
Horizontal Cervix as a Novel Sign for Predicting Adhesions on the Posterior Extrauterine Wall in Cases of Placenta Previa
title Horizontal Cervix as a Novel Sign for Predicting Adhesions on the Posterior Extrauterine Wall in Cases of Placenta Previa
title_full Horizontal Cervix as a Novel Sign for Predicting Adhesions on the Posterior Extrauterine Wall in Cases of Placenta Previa
title_fullStr Horizontal Cervix as a Novel Sign for Predicting Adhesions on the Posterior Extrauterine Wall in Cases of Placenta Previa
title_full_unstemmed Horizontal Cervix as a Novel Sign for Predicting Adhesions on the Posterior Extrauterine Wall in Cases of Placenta Previa
title_short Horizontal Cervix as a Novel Sign for Predicting Adhesions on the Posterior Extrauterine Wall in Cases of Placenta Previa
title_sort horizontal cervix as a novel sign for predicting adhesions on the posterior extrauterine wall in cases of placenta previa
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947443/
https://www.ncbi.nlm.nih.gov/pubmed/31817169
http://dx.doi.org/10.3390/jcm8122141
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