Diagnosis of placenta accreta spectrum in high‐risk women using ultrasonography or magnetic resonance imaging: systematic review and meta‐analysis

Abstract

What are the novel findings of this work?Our findings show that ultrasound and magnetic resonance imaging (MRI) have similar sensitivity and specificity for the diagnosis of placenta accreta spectrum (PAS) in high-risk women. However, the meta-analysis was complicated by heterogeneous subsets of women and methodology across studies. What are the clinical implications of this work?Our systematic review included studies focusing on women who had undergone both MRI and ultrasound examinations, allowing a direct comparison of the two techniques. Given that ultrasound and MRI had similar performance in the diagnosis of PAS in high-risk women, the choice between these modalities could be based on availability of equipment and expertise of the center. However, the pooled sensitivity and specificity of both modalities were far from optimal, suggesting that further exploration of other approaches for the diagnosis of PAS is needed.

Placenta Accreta Spectrum

“…5 In high-risk cohorts, MRI may be equivalent to ultrasonography in diagnostic accuracy. 48 However, caution is warranted in interpreting these data because MRI research for PAS is typically performed in busy referral centers and only in patients who have very high suspicion for PAS based on ultrasonography.…”

An update of diagnostic efficacy of ultrasound and magnetic resonance imaging in the diagnosis of clinically significant placenta accreta spectrum disorders

“…De Oliveira Carniello et al [ 18 ▪▪ ] performed a systematic review and meta-analysis of the diagnostic test accuracy of ultrasound and MRI, also comparing the performance of the two techniques in the diagnosis of PAS. They included observational studies evaluating diagnostic accuracy in women with risk factors for PAS who had undergone both ultrasound and MRI.…”

Effective training program for antenatal diagnosis of placenta accreta spectrum disorder

“…According to previous meta‐analyses, the accuracy of ultrasound for diagnosing PAS ranges from 83% to 95% in experienced centers 15,16 . However, studies have shown that the accuracy of diagnosing PAS disorders depends on operator experience, which may be limited in some tertiary centers 16–18 . with a previous study reporting moderate interobserver variation (κ = 0.47) 19 .…”