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| |  MRI Pinpoints Placenta Accreta With High Specificity: Presented at RSNA By Ed Susman CHICAGO -- December 2, 2009 -- Performing a magnetic resonance imaging (MRI) scan on a pregnant woman suspected to have placenta accreta might allow doctors to rule out the life-threatening complication, researchers noted here at the Radiological Society of North America (RSNA) 95th Annual Meeting. In a recent study, after initial ultrasound showed suspicious or inconclusive results, MRI scans correctly identified about 87.8% of cases of placenta accreta, which required putting a multidisciplined team on alert, stated coinvestigator Michele Brown, MD, University of California San Diego, San Diego, California, speaking at a press briefing here on December 1. MRI also correctly indicated 95.5% of negative cases. To measure the efficacy of MRI for detection of placenta accreta, Dr. Brown and her fellow researchers looked at 108 patients who had had an MRI at their centre between 1992 and 2009 and who were suspected to have the condition. Outcome results were available for 71 of those women. On the MRI scans, an abnormal uterine contour and abnormal placental signal were indicated including dark bands on T2-weighted images, Dr. Brown explained that these are strong indications that placenta accreta exists. Overall, the accuracy of MRI was 90.1%. “Early, accurate diagnosis is very important for this condition because it allows for delivery planning, which improves outcome,” Dr. Brown said. Planning includes a scheduled delivery at 36 to 37 weeks, and arrangements for sufficient blood products to be on hand because of the high blood loss associated with this condition. “Women at high risk for placenta accreta -- such as those who’ve had multiple caesarean sections -- should undergo ultrasound,” Dr. Brown stated. “And if ultrasound is inconclusive, MRI should be considered.” A hysterectomy is usually needed in patients with placenta accreta; in severe cases, massive haemorrhage can occur and 7% of these women die from the complication. Dr. Brown explained that placenta accreta was once relatively rare, but as more and more caesarean deliveries are performed, incidence has increased from 1 in 30,000 births in 1950 to 1 in 533 births today. Although placenta accreta can occur in a woman’s first pregnancy, scar tissue in the uterus created during the caesarean procedure may compromise a specific layer of the endometrium that involves placental attachment, allowing for infiltration into the uterine lining that can cause rupture at the time of delivery. Other risk factors involve any kind of uterine surgery, including abortion, and maternal age over 35. [Presentation title: MR Imaging of Placenta Accreta. Abstract SSJ10-01]
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