MRI in the diagnosis and surgical management of abnormal placentation
Open accessAbstract
Objective. To determine the usefulness of placental magnetic resonance imaging (MRI) in the diagnosis and surgical management of abnormal placentation. Design. Retrospective follow‐up. Setting. Buenos Aires, Argentina. Population. 547 pregnant women. Methods. In all cases, a direct and reliable description of abnormal placentation features was obtained by the operating surgeon. Placental MRI was analyzed according to: (1) primary description, (2) invasion topography, (3) modification required to the surgical tactics or techniques and (4) by positive and negative predictive values. Main outcome measures. Ultrasound and MRI findings were compared with surgical results, which were considered a final diagnosis in relation to primary diagnostic indications. Results. Placental MRI was obtained because of diagnostic doubt in 78 cases, for deep invasion diagnosis in 148 cases and to define the invasion area in 346 cases. Placental MRI allowed accurate demarcation and assessment of the degree of placental invasion, parametrial involvement and cervico‐trigonal vascular hyperplasia, permitting changes in the surgical tactical approach. Ultrasound and MRI differences were associated with placenta previa, uterine scar thinning and use of different criteria for placental invasion through definitions or terminology. Six cases of false‐negative and 11 of false‐positive findings were reported. Conclusion. Placental MRI provides excellent characterization of the degree and extension of placental invasion. Its usefulness in cases of adherent placentation is directly associated to the therapeutic measures, especially where dissection maneuvers are needed. Diagnostic differences between ultrasound and MRI related to the presence or not of placenta previa and uterine scar thinning.
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The main MRI features of placenta accreta include abnormal uterine bulging, dark intraplacental bands on T2-weighted imaging, heterogeneous signal intensity within the placenta, disorganised vasculature of placenta and disruption of the uteroplacental zone.
“The main MRI features of placenta accreta include abnormal uterine bulging, dark intraplacental bands on T2-weighted imaging, heterogeneous signal intensity within the placenta, disorganised vasculature of placenta and disruption of the uteroplacental zone.”
From Placenta Praevia and Placenta Accreta: Diagnosis and Management: Green‐top Guideline No. 27a (2019) · cites this paper as [145]
The Conclusions figure captions (pages unavailable) show myometrial disruption and unusual vascular hyperplasia on MRI in cases of placenta percreta, supporting parts of the claimed imaging picture. Our copy does not identify uterine bulging, dark T2-weighted intraplacental bands, or heterogeneous placental signal as main features, and its vascular finding is not specifically disorganised placental vasculature. (LLM, conf=0.83)
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Placenta Praevia and Placenta Accreta: Diagnosis and Management: Green‐top Guideline No. 27a
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Self-citation
- Authors
- PALACIOS‐JARAQUEMADA, J. M., BRUNO, C. H., & MARTÍN, E.
- Corresponding author
- BRUNO, CLAUDIO HERNÁN
- Venue
- Acta Obstetricia et Gynecologica Scandinavica
- Publisher
- Wiley
- Published
- 2012-11
- Volume
- 92
- Issue
- 4
- Pages
- 392-397
- ISSN
- 0001-6349 (ISSN-L)
- 1600-0412
- OpenAlex
- W1898667567
- Cited by
- 95
- References
- 22
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 10 · 2023: 8 · 2022: 6 · 2021: 7 · 2020: 15 · 2019: 10 · 2018: 11 · 2017: 6 · 2016: 4 · 2015: 6 · 2014: 6 · 2013: 1
- FWCI
- 3.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Acta Obstetricia Et Gynecologica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Keywords
- placental MRI, abnormal placentation, placental invasion, placenta previa, surgical management, parametrial involvement, placental ultrasound, diagnostic accuracy, placenta accreta
- MeSH terms
- Adult, Cesarean Section, Female, Follow-Up Studies, Humans, Hysterectomy, Magnetic Resonance Imaging, Placenta Accreta, Pregnancy, Pregnancy Outcome, Prenatal Diagnosis, Retrospective Studies, Severity of Illness Index, Ultrasonography, Blood Loss, Surgical, Young Adult
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