Abstract
To evaluate the diagnostic power of MRI criteria in, the detection of the placental topography and depth of invasion in, morbidly adherent placenta.
This study included forty pregnant patients, referred to MRI unit with suspected placental invasion by ultrasound. MRI, was done using fast sequences (B-FFE and SSH TSE). Placental topography, architecture and depth of invasion were analysed. MRI criteria suggestive, of invasion were evaluated (loss of retroplacental zone, thick dark, intraplacental bands and disorganized vascularity). The gold standard was, the surgical findings. This study determined the most sensitive, specific, and accurate MRI criteria as well as the degree of agreement with, operative findings.
MRI detected placental invasion in 16 cases out of 40. Operative, findings confirmed 12 of them. MRI achieved100% sensitivity, 85.7%, specificity and 90% accuracy. The MRI criterion of highest, sensitivity, specificity and accuracy was loss of retroplacental zone, (100%, 92.8% and 95% respectively). Good agreement between MRI and the, operative data was encountered (kappa value 0.78).
MRI criteria are accurate markers for the detection and, staging of placental adhesion, which guide the obstetrician to achieve, the optimum surgical management.