MRI-based radiomics nomogram in patients with high-risk placenta accreta spectrum: can it aid in the prenatal diagnosis of intraoperative blood loss?

摘要

Abstract Purpose To develop and validate the nomogram by combining MRI-derived radiomics and clinical features for preoperatively predicting massive intraoperative blood loss (IBL) in high-risk placenta accreta spectrum (PAS) patients.Methods A total of 152 high-risk PAS patients from Hospital A were enrolled and constituted the training cohort, and 64 patients from Hospital B constituted the validation cohort. Clinical features were analyzed retrospectively. Placental regions of interest were manually positioned on sagittal T2-weighted HASTE images for each patient to extract quantitative radiomics features. Clinical model, radiomics model, and nomogram were built to predict the risk of massive IBL. The diagnostic performance was assessed using the area under the receiver operating characteristic curve (AUC) and the DeLong test. Decision curve analysis (DCA) was performed to determine the performance of the best predictive model.Results The nomogram (AUC?=?0.866 and 0.876, respectively) and radiomics model (AUC?=?0.821 and 0.855, respectively) outperformed the clinical model (AUC?=?0.685 and 0.619, respectively) both in the training and validation cohorts (Delong test, P?