Placenta Accreta Spectrum (PAS) Disorder: Ultrasound versus Magnetic Resonance Imaging

Abstract

Objective: PAS is one of the most dangerous conditions associated with pregnancy and remains undiagnosed before delivery in from half to two-thirds of cases. Correct prenatal diagnosis is essential to reduce the burden of maternal and fetal morbidity. The purpose of our study is to evaluate the accuracy of US and MRI in the diagnosis of PAS. Study design: In this retrospective study, 104 patients with suspected placenta accreta were enrolled and had been investigated with US and MRI. They were divided into four groups: no PAS, accreta, increta, and percreta. Results: Compared to MRI, US results were higher in the diagnosis and in the identification of PAS severity (85% US vs. 80% MRI). For both methods, in the case of posterior placenta, there is greater difficulty in identifying the presence/absence of the disease (67% in both methods) and the severity level (61% US vs. 55% MRI). Conclusion: US, properly implemented with the application of defined and standardized scores, can be superior to MRI and absolutely sufficient for the diagnosis of PAS, limiting the use of MRI to a few doubtful cases and to cases in which surgical planning is necessary.

Unexpected Dramatic Evolution of Placenta Increta: Case Report and Literature Review

“…Prenatal ultrasound examinations, particularly specialized imaging techniques like magnetic resonance imaging (MRI) have become valuable tools in visualizing the placental location, depth of invasion, and involvement of adjacent structures. As such, they can help plan for the safest delivery method and potential interventions [14,38]. In fact, ultrasound is the preferred method for diagnosing abnormally invasive placenta during pregnancy, and its diagnostic accuracy has been demonstrated to be reliable in both retrospective and prospective studies [39].…”

The Value of MRI in the Diagnosis of Placenta Previa

“…(2) Exclusion criteria Pregnant women have unbalanced breathing, nervous tension and efficiency, and their cooperation with inspection activities is low; The fetus moves frequently, and the error rate is large when MRI is performed; Pregnant women with other pelvic diseases [3]; Pregnant women who finally stop treatment because they do not meet the inclusion criteria or have adverse events during the study.…”

“…In the diagnosis of placenta previa, MRI technology can directly observe the location and size of the placenta and cervix, and can clearly reflect the distance between the placenta and the cervix, the coverage area and degree of the placenta, as well as the length and opening degree of the cervix [1]. In addition, MRI can also detect abnormal placental lesions, such as placental abruption, placental transposition, placental abruption, placental thickening and other lesions, which helps to take effective treatment measures in time to ensure the health of pregnant women and fetuses [2]. Based on this, this study selected 100 pregnant women with placenta previa to analyze the diagnostic value of MRI.…”

Features of ultrasound diagnosis of pathological placentation

“…Результати УЗД продемонстрували помірний рівень доказовості -коефіцієнт каппа 0,47±0,12 (M±σ) з високою варіабельністю чутливості (53,4-74,4 %), специфічності (70,8-94,8 %) і точності (55,9-76,4 %) [26]. Це пояснює необхідність стандартизації отриманих даних УЗД: European Working Group on Abnormally Invasive Placenta [32] спільно з Ad-hoc International AIP Expert Group [33] запропонували стандартизувати описовий протокол ультразвукового дослідження з чітким описом ультразвукових критеріїв (сірошкальних та допплерографічних) у разі підозри на прирощення плаценти, використовуючи наведені вище ультразвукові ознаки.…”