Prognostic significance of MRI in diagnosing different types of placenta increta
Objective. To estimate the diagnostic value of different MRI signs in determining the extent of placental invasion.Vinitsky A.A., Kulabukhova E.A., Bychenko V.G., Shmakov R.G., Ezhova L.S., Uchevatkina P.V., Pirogova M.M.
Subjects and methods. This retrospective cohort study enrolled 32 patients with morphologically verified diagnosis of placenta increta. All the cases were divided into three groups according to the histological findings of the extent of placental invasion: 1) placenta accreta (n=10); 2) placenta increta (n=20); 3) placenta percreta (n=2).
Results. Central placenta previa was 8.5 times more common in patients with placenta increta. While marginal previa was more characteristic of placenta accreta (p=0.015). Other clinical and anamnestic parameters showed no impact on the extent of placental invasion. Multiple lacunae prevailed 9 times more frequently in placenta increta while more than 1-2 lacunae were detected in placenta accreta. Dark bands are also a more characteristic sign for deeper placental invasion (p=0.04).
Conclusion. The investigation showed a link between the form of abnormal placentation and placental invasion. Multiple lacunae and dark bands are significant MRI markers for the diagnosis of placenta increta.
Keywords
placental ingrowth
MRI
placenta accreta
placenta increta
placenta percreta
Supplementary Materials
- Table 1. Patient demographics and past medical history
- Table 2. Statistical analysis of MR-signs in groups with various degrees of ingrowth of the placenta.
- Figure 1. MRI of the patient's small pelvis for 32 weeks of pregnancy.
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Received 12.10.2017
Accepted 27.10.2017
About the Authors
Vinitskiy A.A., Postgraduate student of maternity departments, National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79253620232. E-mail: drvinitskiy@gmail.comKulabukhova E.A., MD, PhD, radiologist of the radiation diagnostics department, National Medical Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954387647. E-mail: mri-Elena@yandex.ru
Bychenko V.G., MD, PhD, head of the radiation diagnostics department, National Medical Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954387647. E-mail: v_bychenko@oparina4.ru
Shmakov R.G., MD, PhD, the chief medical officer, National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954387300. E-mail: r_shmakov@oparina4.ru
Ezhova L.S., MD, PhD, Senior researcher of morphological department, National Medical Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382892. E-mail: l_ezhova@oparina4.ru
Uchevatkina P.V., MD, radiologist of the radiation diagnostics department , National Medical Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954387647. E-mail: kulpova@mail.ru
Pirogova M.M., Postgraduate student, National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79160944569. E-mail: pirogovamariya@gmail.com
For citations: Vinitsky A.A., Kulabukhova E.A., Bychenko V.G., Shmakov R.G., Ezhova L.S., Uchevatkina P.V., Pirogova M.M. Prognostic significance of MRI in diagnosing different types of placenta increta. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (1): 41-7. (in Russian)
https://dx.doi.org/10.18565/aig.2018.1.41-47
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