Original Research Article
Year: 2019 | Month: August | Volume: 9 | Issue: 8 | Pages: 51-59
Efficacy of Magnetic Resonance Imaging over Ultrasound in the Diagnosis of Placental Invasion
Dr. Chetana R. Ratnaparkhi1, Dr. Sidharth Sharma2, Dr. Avinash P. Dhok3, Dr. Madhuri S. Gawande4, Dr. Shital A. Kurve5, Dr. Sarika H. Kohar5
1Associate Professor, 2Post-graduate Resident, 3Professor and Head of Department, 5Senior Resident,
Department of Radio-diagnosis, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Digdoh Hills, Nagpur, Maharashtra, India.
4Consultant Gynecologist, American Oncology Institute, Nagpur, Maharashtra, India.
Corresponding Author: Dr. Sidharth Sharma
ABSTRACT
Incidence of placental invasion is on rise due to increasing number of caesarean sections. Identification of placental invasion is important to reduce maternal morbidity and mortality. For preoperative assessment of placental invasion, ultrasonography (USG) is the primary imaging modality. Due to its excellent soft tissue resolution and multiplanar imaging, magnetic resonance imaging (MRI) is becoming the modality of choice in placental invasion, particularly where sonographic findings are indistinct. In the current study, we evaluate the usefulness of USG and MRI in diagnosis of placental invasion.
Materials and Methods -Eleven patients of suspected placental invasion were included in the study. Out of eleven, nine were antenatal and two were in postnatal period with retained placenta. All patients were multigravida with previous history of uterine interventions (maximum with previous caesarean section n=9).They were subjected to USG and MRI pelvis examination after acquiring proper written consent. On the basis of imaging placental invasion was classified into placenta accreta, placenta increta and placenta percreta.
Results- On USG, eight patients were labelled as having placenta accreta, one as placenta increta and two as placenta percreta; however the patients diagnosed as placenta percreta on USG turned out to be placenta increta which was confirmed on intraoperative findings. On MRI, placenta accreta was seen in eight patients. This is likely to be attributed to better soft tissue resolution of MRI.
Conclusion- For placental invasion USG is the primary imaging modality, however MRI plays important role in accurately classifying invasion thus helps in management.
Key words: Placental Invasion, Ultrasonography, Magnetic Resonance Imaging