Magnetic resonance imaging versus transabdominal ultrasound about operative findings of placental adhesive disorder

Background: Ultrasonography (US) and magnetic resonance imaging (MRI) have been used for the diagnosis of placental adhesive disorders (PAD). Still, the accuracy of these two imaging techniques remains to be determined and depends on the skills of the sonographer or radiologist. Objectives: To assess the accuracy of MRI & US in evaluating a patient with morbidly adherent placenta. Patients and methods: This prospective cross-sectional study included 25 pregnant women presented with placenta previa and a history of cesarean section (CS) from October 2018 to October 2019 at Al-Yarmook Teaching Hospital, Baghdad, Iraq. Patients were examined by transabdominal ultrasonography (US) and pelvis MRI. Then, each test's accuracy, sensitivity, specificity, Negative predictive value (NPV) and positive predictive value (PPV) were assessed to diagnose placental position and PAD, compared to each other, and correlated with operative findings at the CS. Results: MRI showed high accuracy, sensitivity, specificity, NPV & PPV (100% for each) in assessing placenta position and attachment. In the case of placenta position, the US assessment showed an accuracy of 88%, sensitivity of 91.3%, specificity of 50%, NPV of 33.3% & PPV of 95.4%, while the US assessment in placental attachment showed an accuracy of 88%, sensitivity of 95.4%, specificity of 33.3%, NPV of 50% and PPV of 91.3%. Conclusions: MRI showed very high accuracy in assessing abnormal placentation in both position and attachment, while transabdominal US showed high sensitivity with low specificity.