Magnetic Resonance Imaging MRI versus Color Doppler Ultrasound for Assessment of Placenta Accreta Spectrum Disorders

Abstract

Abstract Background As placenta previa and placenta accreta are the two most common causes of postpartum hemorrhage, early and accurate diagnosis, preoperative assessment, and intraoperative management are crucial for a successful outcome. However, risk assessment of intraoperative massive hemorrhage in patients with placenta previa and accreta is challenging in clinical practice. Aim of the Work To compare the sensitivity and accuracy of MRI versus color Doppler US in the diagnosis of morbidly adherent placenta in women with placenta previa accreta spectrum. Subjects and Methods This was a cohort prospective study was done in cases was recruited from the pregnant women attending outpatient clinic or emergency department at Ain Shams University Maternity Hospital. The study was include 62 pregnant women. Results The final US results shows that from the 90 studied patients; 25 patients have no presence of accreta (37.8%) and 65 patients have presence of accreta (72.2%). The final MRI results shows that from the 90 studied patients; 35 patients have no presence of accreta (38.9%) and 55 patients have presence of accreta (61.1%). there was statistically significant increase in the percentage of patients with history of thyroidectomy and IUD removal laparoscopic in patients with placenta accreta (7.5% and 7.5%; respectively) than patients without placenta accreta (0.0% and 0.0%; respectively) with p-value = 0.049 and 0.049; respectively. there was statistically significant increase in the percentage of accuracy of MRI results (73.3%) than ultrasound results (58.9%). Conclusion Regarding to our results we concluded that ultrasound can detect patients with placenta accreta with sensitivity of 92.5%, specificity of 32.0% and overall accuracy of 58.9% while MRI can detect patients with placenta accreta with sensitivity of 100.0%, specificity of 52.0% and overall accuracy of 73.3%, there was statistically significant increase in the percentage of accuracy of MRI results (73.3%) than ultrasound results (58.9%) with p-value <0.001.