ORIGINAL RESEARCH article
Front. Med.
Sec. Obstetrics and Gynecology
This article is part of the Research TopicNeuroplacentology: From "Start-up" to "Start-map"View all 6 articles
Quantitative Diffusion MRI Biomarkers Predict Adverse Maternal Outcomes in Placenta Accreta Spectrum Disorders
Provisionally accepted
- Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
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Introduction: This study aimed to investigate the potential of diffusion-weighted imaging (DWI) parameters in predicting adverse maternal outcomes in high-risk patients with placenta accreta spectrum (PAS) disorders. Methods: We conducted a prospective analysis of 109 patients with PAS, including 15 who experienced adverse maternal outcomes and 94 who did not. All patients underwent DWI, including intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI). Measured parameters included the apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), mean kurtosis (MK), and mean diffusivity (MD). These parameters were compared between the two groups. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the diagnostic performance of DWI parameters in predicting adverse maternal outcomes. Results: Patients with adverse maternal outcomes exhibited significantly higher MD, D, and D* values but significantly lower MK values (P < 0.05). Multivariate regression analysis identified D and the number of prior cesarean deliveries (CD) as independent predictors of adverse outcomes. The combination of these two factors yielded the highest predictive performance, with an area under the curve (AUC) of 0.766 (95% confidence interval: 0.654–0.878). Discussion: DWI parameters demonstrate a significant association with adverse maternal outcomes in high-risk PAS patients. The combination of prior CD history and the D parameter may serve as a valuable predictive tool for identifying patients at increased risk of complications.
Keywords: Placenta accreta spectrum disorders, diffusion-weighted MRI, Intravoxel incoherent motion, diffusion kurtosis imaging, Magnetic Resonance Imaging
Received: 02 Jun 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Lu, Wang, Huang, Chen and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tao Lu, 345248302@qq.com
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