Radiology · 1997 · 358 citations · 0 references
MedicineGynecologyObstetricsGynecologic UltrasoundMaternal-fetal MedicineObstetric UltrasoundPlacental AssessmentPlacental ImagingPlacental UltrasonographyPregnancy DiagnosisPregnancy ImagingMagnetic ResonancePlacental GradingPower Doppler UltrasonographyPower Doppler UltrasoundThird Trimester UltrasonographyTransabdominal Ultrasound FindingsTransabdominal Uterine Ultrasound
The study aimed to evaluate the diagnostic value of transabdominal, transvaginal, color Doppler, power Doppler ultrasound, and magnetic resonance imaging for placenta accreta. Nineteen high‑risk third‑trimester patients underwent color and power Doppler ultrasound, and 18 also had MR imaging, with images prospectively interpreted by two reviewers who graded diagnostic confidence on a five‑point scale. Vaginal power Doppler ultrasound accurately identified five lower‑uterine‑segment accreta cases, MR imaging detected a posterior accreta missed by ultrasound, and overall the modalities differentiated normal placentas, accreta, and hysterectomy outcomes.
PURPOSE: To determine the value of transabdominal ultrasound (US), transvaginal US, color Doppler US, power Doppler US, and magnetic resonance (MR) imaging in the diagnosis of placenta accreta. MATERIALS AND METHODS: Nineteen patients in the third trimester of pregnancy who were at risk for placenta accreta underwent color Doppler and power Doppler US; 18 patients also underwent MR imaging. Images were interpreted prospectively for signs of accreta by two reviewers. The reviewers' confidence in their diagnosis was graded on a five-point scale. RESULTS: Outcomes at delivery were as follows: normal placenta (n = 11), hysterectomy owing to uncontrollable bleeding (n = 1), and placenta accreta (n = 7). Five cases of lower-uterine-segment placenta accreta were diagnosed with a high level of confidence with vaginal and power Doppler US. In one patient with a posterior placenta who had previously undergone myomectomy, MR imaging enabled the diagnosis of placenta accreta, which was not well depicted at US. CONCLUSION: In patients with a history of uterine scars, vaginal US with power Doppler US performed well in the evaluation of lower-uterine-segment placenta accreta. MR imaging depicts posterior placenta accreta.