title: Magnetic resonance imaging of clinically stable late pregnancy bleeding: beyond ultrasound.
abstract: OBJECTIVE
  To compare the accuracy of magnetic resonance (MRI) and colour Doppler-ultrasound (US) in the diagnosis of late pregnancy bleeding and to assess the accuracy of the different MR sequences in visualizing the origin of haemorrhage.
  
  
  METHODS
  42 patients in the third trimester of pregnancy underwent to US and MRI for the evaluation of painless vaginal bleeding. Multiplanar HASTE, True Fisp, 3D T1 GRE and sagittal DWI sequences were acquired. Two radiologists, blinded to the results of US, reviewed each case, resolving by consensus any discrepancy. Reference standards were surgical and pathological findings.
  
  
  RESULTS
  The reference standards identified 22 placenta previa, 11 placental abruptions (1 coincident with a placental chorioangioma), 1 thrombohaematoma and 1 fibroma with haemorrhagic degeneration. MRI identified correctly all these condition with an interobserver agreement of 0.955. DWI and T1 weighted sequences were statistically superior to Haste and True Fisp sequences in detecting the cause of bleeding (p < .001). US had 6 false negatives and 2 false positive results, its diagnostic accuracy resulting lower than MRI (p = .001).
  
  
  CONCLUSIONS
  MRI accurately evaluates pregnancy bleeding with an excellent interobserver agreement and can grant new and additional data when US is negative.
authors.affiliation: Radiology Dea Department, Umberto I Hospital, Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy. gabrielemasselli@libero.it
authors.forename: Gabriele
authors.initials: G
authors.lastname: Masselli
authors.forename: Roberto
authors.initials: R
authors.lastname: Brunelli
authors.forename: Tiziana
authors.initials: T
authors.lastname: Parasassi
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Perrone
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Gualdi
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015588:Observer Variation; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis*; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D014592:Uterine Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D055815:Young Adult