To review the imaging features of MRI for establishing the diagnosis of morbidly adherent placenta.
To assess placental depth of invasion on MRI in patients with accreta,
increta and percreta.
To establish the ideal MR sequences for diagnosing placental invasiveness.
Introduction and Pathophysiology:
Morbidly adherent placenta (MAP) is a severe pregnancy complication that occurs when the chorionic villi abnormally invade the myometrium.
Its pathogenesis is primarily attributed to defective decidualization of the implantation site.
The increasing incidence of morbidly adherent placenta has greatly increased the risk of a possible threat to life1,
The incidence of MAP has risen substantially due to the increased rate of cesarean sections (CS) 3 and previous damage to myometrial wall,
through prior cesarean section is the most important risk...
Findings and procedure details
Magnetic Resonance Imaging in Morbidly Adherent Placenta:
The maternal pelvis is imaged in the axial,
and sagittal planes with multichannel body surface coil.
The field of view (FOV) is usually 38 cm but can be increased to optimize for the enlarged uterine size.
T2-weighted PROPELLER i.e.
periodically rotated overlapping parallel lines with enhanced reconstruction (PROP) and T2 FATSAT (FatS) images are ideally acquired in the axial,
and coronal planes with repetition/echo times of 2000-4000/98-120 milliseconds,
a slice thickness of 5 mm...
MRI is highly accurate in predicting the radiological patterns of placenta accreta.
Reader accuracy and confidence require adherence to examination performance,
image interpretation criteria,
and awareness of common pitfalls.
T2 PROP is the imaging sequence of choice for percreta and Increta and FIESTA is useful for accreta.
i. MRI of placenta should be performed with moderately full bladder.
MRI sequence combination of T2 PROP and FIESTA should be used in different planes.
All authors are working radiology consultants at Rehman Medical Institute Peshawar.
Ummara Siddique Umer
FCPS (Radiology) ,EDiR (EBR)
Consultant Radiologist &Assistant Professor of Radiology
Rehman Medical Institute Peshawar
We would like to thank Mr.
Shahjahan Khursheedi ,
Junaid and Mr.
Siraj for their help in data collection.
1. Sunil A,
Placenta Accreta Prenatal Diagnosis: Does MRI add to Sonography? J Gynecol Women’s Health.
2016; 1(4): 555569.
2. Varghese B,
Magnetic resonance imaging of placenta accreta.
The Indian Journal of Radiology & Imaging.
3. Sulatana N,
Management of placenta percreta with bladder invasion.
J Pioneer Med Sci.
MRI of Placenta Accreta,