Diagnostic value of ultrasonography and magnetic resonance imaging in pregnant women at risk for placenta accreta

Abstract

US and MRI were useful in the diagnosis of placenta accreta with lacunae and an abnormal color Doppler imaging pattern are the most helpful findings. MRI is most clearly indicated when US findings are ambiguous or there is a posterior placenta.

Diagnóstico prenatal de acretismo placentario: hallazgos y utilidad del ultrasonido y la resonancia magnética. Reporte de casos en el Hospital Universitario de la Fundación Santa Fe de Bogotá (Colombia)

“…La resonancia magnética (RM) puede definir el compromiso uterino y de los órganos vecinos (11,20). Los hallazgos específicos en RM son: abombamiento del útero, placenta de intensidad de señal heterogénea y bandas gruesas intraplacentarias hipointensas en las imágenes potenciadas en T2 (11,15).…”

The Importance of a Late First Trimester Placental Sonogram in Patients at Risk of Abnormal Placentation

“…In our case, these features were visualized at 13 weeks and became more pronounced in the second trimester. According to Elhawary et al [22], the sensitivity and specificity of ultrasound to detect placenta accreta are 82.0% and 89.6%, respectively, while the positive and negative predictive values were 72.7% and 92.8% despite a relatively small sample size ( n = 39). However, Dwyer et al [3] had a similar sample size ( n = 32) and reported 93% sensitivity and 71% specificity in identifying placenta accreta.…”

“…In cases of placenta accreta, increased vascularization of the placental-myometrial interface is an indication of an abnormality [23]. According to Elhawary et al [22], an abnormal color Doppler imaging pattern is a helpful finding for identification of placenta accreta. The most common findings identified by color Doppler are placental lacunae with turbulent blood flow and a hypervascular serosa-bladder interface.…”

“…Similarly, magnetic resonance imaging (MRI), due to limitations of access, will likely not usurp the role of sonography in screening and diagnosis of placenta accreta despite high sensitivities (80–88.8%) and specificities (65–86.6%) [3, 22, 25]. Imaging features on MRI consistent with placenta accreta include the presence of dark intraplacental bands on T2 weighted images, heterogeneous placental signal, uterine wall bulging, and focal interruptions in the myometrial wall [22]. However, MRI may be useful adjunct in uncertain cases and assist with differentiation and elimination of other implantation anomalies including placenta percreta and increta.…”

Non-central nervous system fetal magnetic resonance imaging

“…Recently, several reports of placental abnormalities defined by MRI have appeared [33,34]. In addition, an increasing number of pregnancies are complicated by placental adhesive disorder, and clinicians are requesting imaging for the diagnosis and to aid surgical planning [35,36].…”