Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2013; 23(04): 379-385
DOI: 10.4103/0971-3026.125592
Abdominal Radiology

Magnetic resonance imaging of placenta accreta

Binoj Varghese
Department of Radiodiagnosis, Amala Institute of Medical sciences and Mediscan, Thrissur, Kerala, India
,
Navdeep Singh
Department of Radiodiagnosis, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
,
Regi A.N George
Department of Radiodiagnosis, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
,
Sareena Gilvaz
Department of Gynaecology and Obstetrics, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
  PDF Download Permissions and Reprints

Abstract

Placenta accreta (PA) is a severe pregnancy complication which occurs when the chorionic villi (CV) invade the myometrium abnormally. Optimal management requires accurate prenatal diagnosis. Ultrasonography (USG) and magnetic resonance imaging (MRI) are the modalities for prenatal diagnosis of PA, although USG remains the primary investigation of choice. MRI is a complementary technique and reserved for further characterization when USG is inconclusive or incomplete. Breath-hold T2-weighted half-Fourier rapid acquisition with relaxation enhancement (RARE) and balanced steady-state free precession imaging in the three orthogonal planes is the key MRI technique. Markedly heterogeneous placenta, thick intraplacental dark bands on half-Fourier acquisition single-shot turbo spin-echo (HASTE), and disorganized abnormal intraplacental vascularity are the cardinal MRI features of PA. MRI is less reliable in differentiating between different degrees of placental invasion, especially between accreta vera and increta.

Keywords

Abnormal placental vascularity - dark intraplacental bands - magnetic resonance imaging - placenta accreta


Publication History

Article published online:
30 July 2021

© 2013. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Garmi G, Salim R. Epidemiology, etiology, diagnosis, and management of placenta accreta. Obstet Gynecol Int 2012;2012:873-929.
  • 2 Baughman WC, Corteville JE, Shah RR. Placenta accreta: Spectrum of US and MR imaging findings. RadioGraphics 2008;28:1905-16.
  • 3 Lim PS, Greenberg M, Edelson MI, Bell KA, Edmonds PR, Mackey AM. Utility of ultrasound and MRI in prenatal diagnosis of placenta accreta: A pilot study. AJR Am J Roentgenol 2011;197:1506-13.
  • 4 Derman AY, Nikac V, Haberman S, Zelenko N, Opsha O, Flyer M. MRI of placenta accreta: A new imaging perspective. AJR Am J Roentgenol 2011;197:1514-21.
  • 5 Mohamed AG, Nadia FE, Mohamed AI, Ahmed K. Placenta accreta in women with prior uterine surgery: Diagnostic accuracy of Doppler ultrasonography and MRI. Egypt J Radiol Nucl Med 2012;43:473-80.
  • 6 Dwyer BK, Belogolovkin V, Tran L, Rao A, Carroll I, Barth R, et al. Prenatal diagnosis of placenta accreta: Sonography or magnetic resonance imaging? J Ultrasound Med 2008;27:1275-81.
  • 7 Levine D, Hulka CA, Ludmir J, Li W, Edelman RR. Placenta accreta: Evaluation with color Doppler US, power Doppler US, and MR imaging. Radiology 1997;205:773-7.
  • 8 Warshak CR, Eskander R, Hull AD, Scioscia AL, Mattrey RF, Benirschke K, et al. Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta. Obstet Gynecol 2006;108:573-81.
  • 9 Dehdari A, Williams J. Role of 3T MRI in staging of placenta accreta. Paper presented at: ASM 2010. Royal Australian and New Zealand College of Radiologists, Annual Scientific Meeting; 2010 Oct 14-17; Perth, Western Australia.
  • 10 Masselli G, Brunelli R, Casciani E, Polettini E, Piccioni MG, Anceschi M, et al. Magnetic resonance imaging in the evaluation of placental adhesive disorders: Correlation with color Doppler ultrasound. Eur Radiol 2008;18:1292-9.
  • 11 Comstock CH, Love JJ Jr, Bronsteen RA, Lee W, Vettraino IM, Huang RR, et al. Sonographic detection of placenta accreta in the second and third trimesters of pregnancy. Am J Obstet Gynecol 2004;190:1135-40.
  • 12 Finberg HJ, Williams JW. Placenta accreta: Prospective sonographic diagnosis in patients with placenta previa and prior Cesarean section. J Ultrasound Med 1992;11:333-43.
  • 13 Blaicher W, Brugger PC, Mittermayer C, Schwindt J, Deutinger J, Bernaschek G, et al. Magnetic resonance imaging of the normal placenta. Eur J Radiol 2006;57:256-60.
  • 14 Lax A, Prince MR, Mennitt KW, Schwebach JR, Budorick NE. The value of specific MRI features in the evaluation of suspected placental invasion. Magn Reson Imaging 2007;25:87-93.
  • 15 Teo TH, Law YM, Tay KH, Tan BS, Cheah FK. Use of magnetic resonance imaging in evaluation of placental invasion. Clin Radiol 2009;64:511-6.