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Case Studies | Radiology and Medical Imaging Sciences | India | Volume 13 Issue 5, May 2024 | Rating: 5.2 / 10
Unveiling Placenta Accreta Spectrum: Magnetic Resonance Imaging for Predictive Insights with Intraoperative and Histopathological Correlation
Dr. Jay Hapani [2] | Dr. Jaydip Sukhadiya | Dr. Hiral Hapani [2] | Dr. Anjana Trivedi [5]
Abstract: Introduction: Placenta accreta spectrum (PAS) poses a significant risk during pregnancy, characterized by abnormal placental adherence or invasion into surrounding tissues, often stemming from defects in the spongiosus layer of the placenta basalis. While ultrasound serves as the primary imaging modality, its limitations in visualizing deep-seated placental invasion necessitate the use of magnetic resonance imaging (MRI) for comprehensive evaluation. Objective: Principle objective of this study is to improve prenatal diagnostic accuracy of PAS by placental MRI in high risk pregnant women for PAS. Materials and methods: This retrospective descriptive study was conducted in Department of Radio diagnosis at P.D.U. Medical College and Civil Hospital (tertiary care government centre) from May 2023 to December 2023.This retrospective study has included 23 pregnant women in 2nd and 3rd trimester with high risk of PAS, based on previous history of caesarean delivery or uterine surgery. Intraoperative and final Histopathological impression was compared with available antenatal reported MRI parameter for PAS. Results: Our study has shown that there is high positive coherence between placental invasion and placenta preavia and this was present in all of our cases. Placental heterogeneity and T2 dark placental bands have high coherence with placental invasion but were not specific. Uterine bulge has high specificity for placenta percreta disorder. Conclusion: The escalating incidence of PAS disorders parallels the increasing rate of caesarean deliveries. Accurate antenatal diagnosis and identification of extrauterine invasion are crucial for multidisciplinary planning and improved patient outcomes. While ultrasound remains the initial investigation of choice, MRI serves as a valuable adjunct in cases with inconclusive ultrasound findings, aiding in operative planning by delineating the extent of placental invasion. The integration of multiple MRI features in suspected high-risk pregnant women facilitates the accurate diagnosis of underlying PAS, guiding optimal management strategies.
Keywords: placenta, placental invasion, pas, uterine bulge, T2 dark band. accreta, increta, percreta
Edition: Volume 13 Issue 5, May 2024,
Pages: 1509 - 1515