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| The value of ultrasonography and MRI in the diagnosis of placenta accreta |
| Guangdong Wemen and Children Hospital, Guangzhou 511400, China |
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Abstract Objective: To compare the value of ultrasonography and MRI in the diagnosis of suspected abnormal placental implantation, and discuss ultrasonography and MRI features in patients with placental invasion. Methods: The sonographic and MRI scan of 256 patients at risk of placenta accreta was reviewed retrospectively. Finding patients of placenta accreta with ultrasound and MRI were compared with clinical findings with delivery, and then compared the value of ultrasonography and MRI in the diagnosis of suspected abnormal placental implantation. Results: Of the 256 patients at risk of placenta accreta, 50 patients were confirmed with abnormal placental implantation by the operative finding. Ultrasonography was correctly identified in 32 of 50 patients with placenta accreta, sensitivity 64.0%, specificity 99.5%, positive predictive value 97.0%, negative predictive value 91.9%. With MRI, abnormal placentations were correctly identified in 39 of 50 patients, with sensitivity 78.0%, specificity 99.5%, positive predictive value 97.5%, and negative predictive value 94.9%. Ultrasonography and MRI showed no statistically difference in identifying patients with abnormal placental implantation(P>0.05). The main features of placental implantation on ultrasonography were intraplacental lacunae and loss of the normal retroplacental clear space, bigger vascular lake and increased vascularization in placenta or uterine and serosa interface. At MRI, blurred of the interface placenta and uterine myometrium, uterine bulging and the presence of dark intraplacental bands on SSFSE images in intraplacental or uterine and serosa interface are of the main features of placental implantation. Conclusion: Both ultrasound and MRI have higher diagnostic value in placental implantation. There are both specific findings in placenta accreta on ultrasonography and MRI.
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Received: 28 July 2015
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Corresponding Authors:
JIANG Kui-ming
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