Texture analysis of placental MRI: can it aid in the prenatal diagnosis of placenta accreta spectrum?

Eric Chen, Winnie A. Mar*, Jeanne M. Horowitz, Amanda Allen, Priyanka Jha, Donald R. Cantrell, Kejia Cai

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Purpose: To determine if texture analysis can differentiate placenta accreta spectrum (PAS) from normal placenta on MRI. Methods: We performed retrospective image analysis of 80 patients, comprised of 46 patients with PAS and 34 patients without PAS. Histopathology was used as the reference standard. Sagittal single shot fast spin echo T2-weighted MRI sequences acquired from a single institution were analyzed. Placental heterogeneity was quantified using in-house software on a Matlab platform, including the standard deviation of pixel intensity, coefficient of variation, gray-level co-occurrence matrices (GLCM), histogram-oriented gradients (HOG), and fractal analysis with box sizes from 2 to 512. Two-tailed unpaired Student’s t test was used with statistical significance of p < 0.05. Results: PAS was associated with higher values for standard deviation of pixel intensity and fractal analysis at every box size. Fractal analysis at box sizes 256 (p = 0.011) and 32 (p = 0.021), and standard deviation of pixel intensity (p = 0.023) were the most statistically significant. Fractal values at box size 256 for PAS was 0.13 versus 0.090 for patients without PAS, while standard deviation of pixel intensity was 3.7 for PAS versus 2.5 for patients without PAS. No statistically significant association between PAS and GLCM, coefficient of variation, and HOG was found. Conclusion: Statistically significant differences were found between normal and abnormal groups using standard deviation of pixel intensity and fractal analysis.

Original languageEnglish (US)
Pages (from-to)3175-3184
Number of pages10
JournalAbdominal Radiology
Issue number9
StatePublished - Sep 15 2019


  • Fractal analysis
  • MRI
  • Placenta accreta
  • Placenta accreta spectrum
  • Texture analysis

ASJC Scopus subject areas

  • Gastroenterology
  • Urology
  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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