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Clinical Article
MRI in the diagnosis of placenta accreta
ZHENG Ci-na  YANG Tian-he  LIN Jian-zhong  XU Shang-ren  ZENG Qiang  LI Xiao-qing 

DOI:10.12015/issn.1674-8034.2017.08.007.


[Abstract] Objective: To analyze the features and diagnostic value of MRI in placenta implantation abnormality (PIA).Materials and Methods: Sixty-five cases placenta previa underwent MRI scans, compare with comfirmed clinically or pathologically, obtained the sensitivity, accuracy and analyze the MRI appearances.Results: Placenta accreta was found in 12 cases, placenta increta in 18 cases. The direct signs of PIA were as follows: the bottom of decidual low signal being blurred or interrupt, myometrium becoming thinner or interrupted. The indirect signs of PIA were as follows: lower uterine segment bulging, local thickening and heterogeneous signals of placenta, the intraplacenta vascularity becoming thickening and increasing. The sensitivity, specificity, positive predictive value, negative predictive value were 90.9%, 89.7%, 88.2%, 92.1%.Conclusion: MRI has a high diagnostic value for PIA, and it can guide the clinical to maka effective treatment and reduce the complications.
[Keywords] Placenta accreta;Placenta previa;Prenatal diagnosis;Magnetic resonance imaging

ZHENG Ci-na Department of MRI, Zhongshan Affiliated Hospital of Xiamen University, Xiamen 361004, China

YANG Tian-he* Department of MRI, Zhongshan Affiliated Hospital of Xiamen University, Xiamen 361004, China

LIN Jian-zhong Department of MRI, Zhongshan Affiliated Hospital of Xiamen University, Xiamen 361004, China

XU Shang-ren Department of Kaiyuan street community health service center, Zhongshan Affiliated Hospital of Xiamen University, Xiamen 361004, China

ZENG Qiang Department of MRI, Zhongshan Affiliated Hospital of Xiamen University, Xiamen 361004, China

LI Xiao-qing Department of MRI, Zhongshan Affiliated Hospital of Xiamen University, Xiamen 361004, China

*Correspondence to: Yang TH, E-mail: yth13606916211@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of Xiaman Science and Technology Plan Instructional Program No. 3502Z20149008
Received  2017-01-24
Accepted  2017-06-12
DOI: 10.12015/issn.1674-8034.2017.08.007
DOI:10.12015/issn.1674-8034.2017.08.007.

[1]
Rahman J, Al-Ali M, Qutub HO, et al. Emergency obstetric hysterectomy in a university hospital: A 25-year review. J Obstet Gynaecol, 2008, 28(1): 69-72.
[2]
Hudon L, Belfort MA, Broome DR. Diagnosis and management of placenta percreta: A review. Obstet Gynecol Surv, 1998, 53(8): 509-517.
[3]
Palacios JJM, Bruno CH. Magnetic resonance imaging in 300 cases of placenta accreta:surgical correlation of new findings. Acta Obstet Gynecol Scand, 2005, 84(8): 716-724.
[4]
Thia EW, Lee SL, Tan LK, et al. Ultrasonographical features of morbidly-adherent placentas.Singapore Med J, 2007, 48(9): 799-802.
[5]
Wu S, Kocherginsky M, Hibbard JU. Abnormal placentation: Twenty-year analysis. Am J Obstet Gynecol, 2005, 192(3): 458-1461.
[6]
Yang QH, Li J, Song M, et al. Clinical analysis of 18 cases of placenta previa complicated with placenta accrete. Chin Maternal and Child Health, 2008, 23(20): 2802-2803.杨秋红,李娟,宋敏,等.前置胎盘合并胎盘植入18例临床分析.中国妇幼保健,2008,23(23):2802-2803.
[7]
Horowitz JM, Berggruen S, Mccarthy RJ, et al. When timing is everything: Are placental MRI examinations performed before 24 weeks' gestational age reliable?. AJR, 2015, 205(3): 685-692.
[8]
Budorick NE, Figueroa R, Vizcarra M, et al. Another look at ultrasound and magnetic resonance imaging for diagnosis of placenta accreta. J Matern Fetal Neonatal Med, 2016, 24: 1-6.
[9]
Adams HJA, Kwee TC, Vermoolen MA, et al. Whole-body MRI vs. CT for staging lymphoma: patient experience. Eur J Radiol, 2014, 83(1): 163-166.
[10]
Leyendecker JR, Dubose M, MHosseinzadeh K, et al. MRI of pregnancy-related issues: abnormal placentation. AJR, 2012, 198(2): 311-320.
[11]
Wibke B, Brugger PC, Christoph M, et al. Magnetic resonance imaging of the normal placenta. Eur J Radiol, 2006, 57(2): 256-260.
[12]
Sato T, Mori N, Hasegawa O, et al. Placental recess accompanied by a T2 dark band: a new finding for diagnosing placental invasion. Abdom Radiol, 2017, 14(3): 1-8.
[13]
Derman AY, Nikac V, Haberman S, et al. MRI of placenta accrete: a new imaging perspective. AJR, 2011, 197(6): 1514-1521.
[14]
Levine D. Obstetric MRI. J Magn Reson Imaging, 2006, 24(1): 1-15.
[15]
Zheng XL, Xu JM, Yang MJ. MRI diagnosis and classification of placenta increta in the third trimester of pregnancy. Radiol Pratice, 2015, 30(3): 264-268.郑小丽,徐坚民,杨敏洁.晚孕期胎盘植入的MRI诊断及分型.放射学实践,2015,30(3):264-268.
[16]
D' Antonio F, Iacovella C, Bhide A, et al. Prenatal identification of invasive placentation using magnetic resonance imaging: systematic review and mata-analysis. Ultrasound Obst Gyn, 2014, 44(1): 8-16.
[17]
Millischer AE, Deloison B, Silvera S, et al. Dynamic contrast enhanced MRI of the placenta: A tool for prenatal diagnosis of placenta accreta?. Placenta, 2017, 53(5): 40-47.
[18]
Yang ZH, Xie JX, Wang WZ, et al. Evaluation of true-FISP T2*- weighted MR imaging in the liver. Chin J Radiol, 2000, 34(7): 448-451.杨正汉,谢敬霞,王伟中,等.真实稳态进动快速成像T2加权序列在肝脏的应用价值.中华放射学杂志,2000,34(7):448-451.
[19]
Morita S, Ueno E, Fujimura M, et al. Feasibility of diffusion weighted MRI for defining placental invasion. J Magn Reson Imaging, 2009, 30(3): 666-671.

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