Keywords:
Abdomen, Obstetrics (Pregnancy / birth / postnatal period), Foetal imaging, MR, Diagnostic procedure, Education and training, Artifacts, Obstetrics
Authors:
G. Papaioannou1, P. Tagalakis1, I. zambelis1, N. Kritikos1, C. Malamateniou2; 1Athens/GR, 2LONDON/UK
DOI:
10.1594/ecr2018/C-2057
Aims and objectives
To present the practicalities and clinical findings of imaging the placenta in a High Field Open (HFO) Magnet 1T.
Introduction:The placenta is named after the Greek word plakuos,
meaning "flat cake" and is responsible for the nutritive,
respiratory and excretory functions of the fetus.
It only receives attention when an abnormality is detected in the regular fetal sonographic scan.
During the course of the pregnancy both the placenta appearance and its location change; thus imaging evaluation of the location with MRI is ideally delayed and performed during the end of the third trimester.
Since the nationwide increase of the caesarean sections,
there has been an increase in the number of the abnormally implanted placentae.
Placenta previa refers to abnormal implantation of the placenta in the lower uterine segment,
overlying or near the internal cervical os.
It can be further subdivided according to its position relative to the internal cervical os in low-lying,
marginal,
complete previa and central previa placenta.
Previous uterine surgery predisposes to abnormal adherence or penetration of the chorionic villi to or into the uterine wall,
the extent of which further subdivides the "abnormal" placenta to: placenta accreta (superficial invasion of the basalis layer),
placenta increta (deeper invasion of the myometrium) and placenta percreta (even deeper invasion of the serosa or adjacent pelvic organs),
which may lead to thanatophoric hemorrhage at the time of the placental delivery,
often necessitating emergent hysterectomy.
Whilst the tendency in the research literature is to move towards higher field MRI scanners,
the judicious and resourceful use of a low field scanner such as the one we had available ensures highly favourable results in terms of image quality and patient comfort.