Role of Magnetic Resonance Imaging in the Antenatal Diagnosis of Placenta Accreta - A Case Report

2020 ◽  
pp. 26-29
Author(s):  
OJS Admin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Placenta Accreta ◽  
Antenatal Diagnosis ◽  
Placenta Previa ◽  
Color Doppler ◽  
Myometrial Invasion ◽  
Resonance Imaging ◽  
Gadolinium Contrast ◽  
Chorionic Villi

Placenta Previa (PP) is the abnormal presence of placenta in front of internal os and can be classified into three types (Marginal, partial and complete PP. Transabdominal ultrasound is an effective modality toevaluate PP. Placenta Accreta (PA) occurs when chorionic villi insert deep into the myometrium due to imperfection of decidua basalis. PAis classified on the basis of myometrial invasion. The mildest form of PAis placenta accreta Vera which is classified as attachment of chorionic villi to the myometrium but sparing the muscle. There are 10% chances of PA in women with the initial diagnosis of PP. Previous cesarean section and advanced maternal age are independent risk factors for this high-risk group. Undiagnosed PP is related to significant maternal mortality (up to 25%) and morbidity which occurs due to intrapartum hemorrhage, uterine rupture, abscess formation, and bladder and rectum invasion. The reliability of Brightness mode and color Doppler ultrasound varies widely in different studies for antenatal diagnosis of PA. Magnetic resonance imaging, with and without gadolinium contrast, has been scrutinized as the modality for the greater precision of the antenatal diagnosis of PA in recent times.

Ultrasound and magnetic resonance imaging in the diagnosis of clinically significant placenta accreta spectrum disorders

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Cecilia Cavalli ◽  
Claudia Maggi ◽  
Sebastiana Gambarini ◽  
Anna Fichera ◽  
Amerigo Santoro ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Color Doppler ◽  
Histopathological Diagnosis ◽  
Resonance Imaging ◽  
Placenta Accreta Spectrum ◽  
Clinically Significant ◽  
Placental Lacunae

Abstract Objectives We aimed to assess the performance of ultrasound (US) and magnetic resonance imaging (MRI) signs for antenatal detection of placenta accreta spectrum (PAS) disorders in women with placenta previa (placental edge ≤2 cm from the internal uterine orifice, ≥260/7 weeks’ gestation) with and without a history of previous Caesarean section. Methods Single center prospective observational study. US suspicion of PAS was raised in the presence of obliteration of the hypoechoic space between uterus and placenta, interruption of the hyperechoic uterine-bladder interface and/or turbulent placental lacunae on color Doppler. All MRI studies were blindly evaluated by a single operator. PAS was defined as clinically significant when histopathological diagnosis was associated with at least one of: intrauterine balloon placement, compressive uterine sutures, peripartum hysterectomy, uterine or hypogastric artery ligature, uterine artery embolization. Results A total of 39 women were included: 7/39 had clinically significant PAS. There were 6/18 cases of PAS with anterior placenta: hypoechoic space interruption and placental lacunae were the most sensitive sonographic signs (83%), while abnormal hyperechoic interface was the most specific (83%). On MRI, focal myometrial interruption and T2 intraplacental dark bands showed the best sensitivity (83%), bladder tenting had the best specificity (100%). 1/21 women with posterior placenta had PAS. There was substantial agreement between US and MRI in patients with anterior placenta (κ=0.78). Conclusions US and MRI agreement in antenatal diagnosis of clinically significant PAS was maximal in high-risk women. Placental lacunae on ultrasound scan and T2 intraplacental hypointense bands on MRI should trigger the suspicion of PAS.

Prenatal Diagnosis of Placenta Accreta and Percreta With Ultrasonography, Color Doppler, and Magnetic Resonance Imaging

2004 ◽  
Vol 104 (3) ◽  
pp. 537-540 ◽  
Author(s):  
Pekka Taipale ◽  
Maija-Riitta Orden ◽  
Marja Berg ◽  
Hannu Manninen ◽  
Irina Alafuzoff
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prenatal Diagnosis ◽  
Magnetic Resonance ◽  
Placenta Accreta ◽  
Color Doppler ◽  
Resonance Imaging

scholarly journals Assessment of Sensitivity and Specificity of Ultrasound and Magnetic Resonance Imaging in the Diagnosis of Placenta Accreta

2018 ◽  
Vol 41 (01) ◽  
pp. 017-023 ◽  
Author(s):  
Elisa Lopes ◽  
Francisco Feitosa ◽  
Antonio Brazil ◽  
José de Castro ◽  
Jesus da Costa ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Resonance Imaging ◽  
Chi Squared ◽  
History Of ◽  
The Mean

Objective To assess and compare the sensitivity and specificity of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta in patients with placenta previa. Methods This retrospective cohort study included 37 women, and was conducted between January 2013 and October 2015; 16 out of the 37 women suffered from placenta accreta. Histopathology was considered the gold standard for the diagnosis of placenta accreta; in its absence, a description of the intraoperative findings was used. The associations among the variables were investigated using the Pearson chi-squared test and the Mann-Whitney U-test. Results The mean age of the patients was 31.8 ± 7.3 years, the mean number of pregnancies was 2.8 ± 1.1, the mean number of births was 1.4 ± 0.7, and the mean number of previous cesarean sections was 1.2 ± 0.8. Patients with placenta accreta had a higher frequency of history of cesarean section than those without it (63.6% versus 36.4% respectively; p < 0.001). The mean gestational age at birth among women diagnosed with placenta previa accreta was 35.4 ± 1.1 weeks. The mean birth weight was 2,635.9 ± 374.1 g. The sensitivity of the ultrasound was 87.5%, with a positive predictive value (PPV) of 65.1%, and a negative predictive value (NPV) of 75.0%. The sensitivity of the magnetic resonance imaging was 92.9%, with a PPV of 76.5%, and a NPV of 75.0%. The kappa coefficient of agreement between the 2 tests was 0.69 (95% confidence interval [95%CI]: (0.26–1.00). Conclusion The ultrasound and the magnetic resonance imaging showed similar sensitivity and specificity for the diagnosis of placenta accreta.

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