Assessing the Role of Magnetic Resonance Imaging in the Management of Gravid Patients at Risk for Placenta Accreta

McLean, Logan A.; Heilbrun, Marta E.; Eller, Alexandra; Kennedy, Anne; Woodward, Paula J.

doi:10.1016/j.acra.2011.04.018

Cited by 47 publications

(24 citation statements)

References 19 publications

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“…In these situations MRI appears to be helpful because it can reveal signs not visible by ultrasound (dark intraplacental bands, for example) which can be used to confirm or refute the diagnosis of placenta accreta. On the other hand, if there is a strong suspicion of placenta accreta or percreta at Doppler ultrasound, with several signs present with good PPV, the result of the MRI exam should not alter the obstetric management [36]. Because of the possible burden for the patient in the case of placenta accreta, she should be referred to an appropriate institution for perpartum management and the placenta should be considered as accreta when organizing the course of delivery.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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PurposeTo evaluate the accuracy of ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of placenta accreta and to define the most relevant specific ultrasound and MRI features that may predict placental invasion.Material and MethodsThis study was approved by the institutional review board of the French College of Obstetricians and Gynecologists. We retrospectively reviewed the medical records of all patients referred for suspected placenta accreta to two university hospitals from 01/2001 to 05/2012. Our study population included 42 pregnant women who had been investigated by both ultrasonography and MRI. Ultrasound images and MRI were blindly reassessed for each case by 2 raters in order to score features that predict abnormal placental invasion.ResultsSensitivity in the diagnosis of placenta accreta was 100% with ultrasound and 76.9% for MRI (P = 0.03). Specificity was 37.5% with ultrasonography and 50% for MRI (P = 0.6). The features of greatest sensitivity on ultrasonography were intraplacental lacunae and loss of the normal retroplacental clear space. Increased vascularization in the uterine serosa-bladder wall interface and vascularization perpendicular to the uterine wall had the best positive predictive value (92%). At MRI, uterine bulging had the best positive predictive value (85%) and its combination with the presence of dark intraplacental bands on T2-weighted images improved the predictive value to 90%.ConclusionUltrasound imaging is the mainstay of screening for placenta accreta. MRI appears to be complementary to ultrasonography, especially when there are few ultrasound signs.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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“…Although MRI has a high predictive accuracy in assessing both the depth and topography of placental invasion, there is no difference in either the sensitivity or the specificity between ultrasound and MRI for the detection of invasive placentation [12]. When used in conjunction with ultrasound, MRI rarely changes the surgical management of MAP [13]. Also, despite the high diagnostic accuracy of ultrasonography and MRI in the diagnosis of MAP, there remain some questions around the consistency and interobserver agreement of their interpretation.…”

Section: Discussionmentioning

confidence: 99%

Could Elastography Be Used in the Prediction of Morbidly Adherent Placentation?

Davie

Wong

Clapham

et al. 2016

Case Reports in Obstetrics and Gynecology

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Morbidly adherent placentation (MAP) is a condition in which the placenta is abnormally attached to the uterine myometrium. MAP is a complication of pregnancy that can cause significant morbidity to the mother and fetus and therefore early diagnosis is crucial in its management and prevention of adverse outcomes. Ultrasonography remains the primary diagnostic tool for MAP, with magnetic resonance imaging (MRI) serving as a secondary diagnostic modality. Elastography is a relatively new concept in ultrasound based imaging, which has found application in several fields of medicine, including obstetrics, primarily for evaluation of the firmness of cervical tissue in a preterm labour setting. We report a case on a patient who was diagnosed with placenta increta on ultrasound, aided by elastography and her subsequent management with an en bloc hysterectomy.

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“…Whenever both modalities are used the most suspicious findings have to be used to decide on the management irrespective of the modality. 2,29 A meta-analysis of the performance of MRI in the prenatal diagnosis of placenta accreta involving 18 studies and 1010 pregnancies found it to be highly accurate in the diagnosis of invasive placentation. 30 MRI was found to have a high predictive accuracy in assessing the depth as well the topography of invasive placenta with a sensitivity of 94% and a specificity of 84%.…”

Section: Mri Evaluation Of Placenta Accretamentioning

confidence: 99%

Morbidly Adherent Placenta: Ultrasound Assessment and Supplemental Role of Magnetic Resonance Imaging

Shetty

Dryden

2015

Seminars in Ultrasound, CT and MRI

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Assessing the Role of Magnetic Resonance Imaging in the Management of Gravid Patients at Risk for Placenta Accreta

Cited by 47 publications

References 19 publications

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

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

Could Elastography Be Used in the Prediction of Morbidly Adherent Placentation?

Morbidly Adherent Placenta: Ultrasound Assessment and Supplemental Role of Magnetic Resonance Imaging

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