title: Assessment of total placenta previa by magnetic resonance imaging and ultrasonography to detect placenta accreta and its variants.
abstract: OBJECTIVE
  To evaluate the importance of ultrasonography (US) and magnetic resonance imaging (MRI) in detecting placental adherence defects.
  
  
  METHODS
  Patients diagnozed with total placenta previa (n = 40) in whom hysterectomy was performed due to placental adherence defects (n = 20) or in whom the placenta detached spontaneously after a Cesarean delivery (n = 20) were included into the study between June 2008 and January 2011, at the Department of Obstetrics and Gynecology Ege University (lzmir Turkey). Gray-scale US was used to check for any placental lacunae, sub-placental sonolucent spaces or a placental mass invading the vesicouterine plane and bladder Intra-placental lacunar turbulent blood flow and an increase in vascularization in the vesicouterine plane were evaluated with color Doppler mode. Subsequently all patients had MRI and the results were compared with the histopathologic examinations.
  
  
  RESULTS
  The sensitivity of MRI for diagnosis of placental adherence defects before the operation was 95%, with a specificity of 95%. In the presence of at least one diagnostic criterion, the sensitivity and specificity of US were 87.5% and 100% respectively, while the sensitivity of color Doppler US was 62.5% with a specificity of 100%.
  
  
  CONCLUSIONS
  Currently MRI appears to be the gold standard for the diagnosis of placenta accreta. None of the ultrasonographic criteria is solely sufficient to diagnose placental adherence defects, however they assist in the diagnostic process.
authors.affiliation: Department of Obstetrics and Gynecology, Ege University Faculty of Medicine, Izmir Turkey.
authors.forename: Nuri
authors.initials: N
authors.lastname: Peker
authors.forename: Volkan
authors.initials: V
authors.lastname: Turan
authors.forename: Mete
authors.initials: M
authors.lastname: Ergenoglu
authors.forename: Ozgur
authors.initials: O
authors.lastname: Yeniel
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sever
authors.forename: Mert
authors.initials: M
authors.lastname: Kazandi
authors.forename: Osman
authors.initials: O
authors.lastname: Zekioglu
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D008279:Magnetic Resonance Imaging; D010920:Placenta / Q000000981:diagnostic imaging / Q000473:pathology; D010921:Placenta Accreta / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D010923:Placenta Previa / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal / Q000379:methods; D016387:Women's Health; D055815:Young Adult