The value of specific MRI features in the evaluation of suspected placental invasion

Lax, Allison; Prince, Martin R.; Mennitt, Kevin; Schwebach, J. Reid; Budorick, Nancy E.

doi:10.1016/j.mri.2006.10.007

Cited by 250 publications

(210 citation statements)

References 16 publications

(22 reference statements)

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“…This is because placenta accreta originally has only deficiencies of the decidua without deep invasion into the myometrium by trophoblastic tissue and has no focal thinning of the myometrium (2)(3)(4)(5). A problem of DWI is that the myometrium during the third trimester is commonly thin.…”

Section: Discussionmentioning

confidence: 99%

“…PLACENTAL INVASION is defined as an abnormal adherence of the placenta to the uterine wall with a deficiency of the deciduas basalis (1)(2)(3)(4)(5). According to the degree of invasion of the chorionic villi, it is histologically classified into three types: placenta accreta in which the villi attach to the myometrium; placenta increta in which the villi invade the myometrium; and placenta percreta in which the villi invade the other organs through the uterine serosa (2)(3)(4)(5).…”

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confidence: 99%

“…According to the degree of invasion of the chorionic villi, it is histologically classified into three types: placenta accreta in which the villi attach to the myometrium; placenta increta in which the villi invade the myometrium; and placenta percreta in which the villi invade the other organs through the uterine serosa (2)(3)(4)(5). Due to the increase in cesarean deliveries, the incidence of placental invasion accompanied by placenta previa has increased dramatically (1,2).…”

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confidence: 99%

“…Magnetic resonance imaging (MRI) has recently been used as an additional diagnostic tool when the clinical suspicion of placental invasion is high and/or the US results are inconclusive, especially in the case of posterior wall attachment (1)(2)(3)(4)(5). A direct MRI finding of placental invasion is focal thinning of the myometrium caused by the invasion of the placenta (3).…”

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confidence: 99%

“…A direct MRI finding of placental invasion is focal thinning of the myometrium caused by the invasion of the placenta (3). However, this is difficult to identify without gadolinium-enhancement because the contrast between the placenta and myometrium is weak on conventional MRI sequences (4).…”

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confidence: 99%

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Feasibility of diffusion‐weighted MRI for defining placental invasion

Morita

Ueno

Fujimura

et al. 2009

Magnetic Resonance Imaging

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The purpose of this clinical note is to describe the feasibility of using diffusion‐weighted imaging for diagnosing placental invasion with a case of placenta increta and six cases without it. Diffusion‐weighted imaging (DWI) at a b‐value of 1000 sec/mm2 can clearly define the border between the placenta and myometrium because only the placenta shows very high signal intensity. The corresponding image at a b‐value of 0 sec/mm2 shows the myometrium with high signal intensity compared with the surrounding fat. Therefore, fusion of the two images can be used additionally to visualize thickness of the myometrium. As a result, DWI can be used to visualize the focal thinning of the myometrium caused by placenta increta, which has been difficult to diagnose on conventional magnetic resonance imaging sequences without contrast enhancement. However, the use of DWI for placental invasion should be determined following careful consideration of its risks and benefits, as fetus safety has not been established. J. Magn. Reson. Imaging 2009;30:666–671. © 2009 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%