Placenta accreta: evaluation with color Doppler US, power Doppler US, and MR imaging.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
Levine
D
D
Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Hulka
C A
CA
Ludmir
J
J
Li
W
W
Edelman
R R
RR
D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010920:Placenta / Q000473:pathology; D010921:Placenta Accreta / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D011247:Pregnancy; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal