Accuracy of Ultrasonography and Magnetic Resonance Imaging in the Diagnosis of Placenta Accreta

Warshak, Carri R.; Hull, Andrew; Benirschke, Kurt; Resnik, Robert

doi:10.1097/01.aog.0000252287.35640.66

Cited by 102 publications

(186 citation statements)

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“…PLACENTAL INVASION is defined as an abnormal adherence of the placenta to the uterine wall with a deficiency of the deciduas basalis (1)(2)(3)(4)(5). According to the degree of invasion of the chorionic villi, it is histologically classified into three types: placenta accreta in which the villi attach to the myometrium; placenta increta in which the villi invade the myometrium; and placenta percreta in which the villi invade the other organs through the uterine serosa (2)(3)(4)(5).…”

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confidence: 99%

“…According to the degree of invasion of the chorionic villi, it is histologically classified into three types: placenta accreta in which the villi attach to the myometrium; placenta increta in which the villi invade the myometrium; and placenta percreta in which the villi invade the other organs through the uterine serosa (2)(3)(4)(5). Due to the increase in cesarean deliveries, the incidence of placental invasion accompanied by placenta previa has increased dramatically (1,2). Image diagnosis of placental invasion can be of great benefit to surgeons for their preoperative planning, because placental invasion can cause life-threatening hemorrhage when the placenta is removed.…”

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confidence: 99%

“…Image diagnosis of placental invasion can be of great benefit to surgeons for their preoperative planning, because placental invasion can cause life-threatening hemorrhage when the placenta is removed. This can be avoided by performing a hysterectomy with the placenta remaining in the uterus (1,2).…”

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confidence: 99%

“…Ultrasonography (US) is commonly used as the screening method for placental invasion (1,2). Magnetic resonance imaging (MRI) has recently been used as an additional diagnostic tool when the clinical suspicion of placental invasion is high and/or the US results are inconclusive, especially in the case of posterior wall attachment (1)(2)(3)(4)(5).…”

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confidence: 99%

“…Magnetic resonance imaging (MRI) has recently been used as an additional diagnostic tool when the clinical suspicion of placental invasion is high and/or the US results are inconclusive, especially in the case of posterior wall attachment (1)(2)(3)(4)(5). A direct MRI finding of placental invasion is focal thinning of the myometrium caused by the invasion of the placenta (3).…”

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confidence: 99%

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Feasibility of diffusion‐weighted MRI for defining placental invasion

Morita

Ueno

Fujimura

et al. 2009

Magnetic Resonance Imaging

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The purpose of this clinical note is to describe the feasibility of using diffusion‐weighted imaging for diagnosing placental invasion with a case of placenta increta and six cases without it. Diffusion‐weighted imaging (DWI) at a b‐value of 1000 sec/mm2 can clearly define the border between the placenta and myometrium because only the placenta shows very high signal intensity. The corresponding image at a b‐value of 0 sec/mm2 shows the myometrium with high signal intensity compared with the surrounding fat. Therefore, fusion of the two images can be used additionally to visualize thickness of the myometrium. As a result, DWI can be used to visualize the focal thinning of the myometrium caused by placenta increta, which has been difficult to diagnose on conventional magnetic resonance imaging sequences without contrast enhancement. However, the use of DWI for placental invasion should be determined following careful consideration of its risks and benefits, as fetus safety has not been established. J. Magn. Reson. Imaging 2009;30:666–671. © 2009 Wiley‐Liss, Inc.

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