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OC30.07: Comparison of the diagnostic value of sonography and MRI in patients with abnormally invasive placenta

Objectives: Abnormally invasive placenta (AIP) is a challenging problem for an obstetrician. Thus, precise prenatal diagnosis is crucial in the management of suspected AIP. Methods: We assessed 106 cases of suspected AIP in the third trimester. All cases underwent ultrasound assessment (US) as well as MRI scan in reference centre for AIP (tertiary level hospital). AIP was confirmed during surgery and histologically. The information value of US and MRI signs in the identification of AIP was compared. Results: A total of 92 cases were confirmed with AIP. The average term of pathology diagnosis was 26 weeks, moda 32 weeks. Overall, US was found to be more sensitive and specific compared to MRI (sensitivity (Se) of 97,8% vs 65,2 and specificity (Sp) of 50% vs 42,9%, respectively). Positive predictive value for US and MRI was 92,8% vs 88,2%, negative predictive value 77,8% vs 15,8%. Accuracy of the methods was 91,5% vs 62,3% respectively. Colour Doppler data (subplacental hypervascularity and bridging vessels) had the highest Se (60,1%) among the US-predictors, among the MRI predictors dark intraplacenal bands on T2 weighted sequences and focal interruption of the myometrium had Se (38%). Only one US sign was present in 3 cases, 2 – in 20, 3 in 28, 4 – in 25, more 4 – in 14. Only one MRI sign was in 32 cases, 2 – in 16, 3 – in 10, 4 in 2, more than 4 – none. The average number of signs per patient was: for US examination – 3,3; for MRI – 1,7. Furthermore, none of the cases misdiagnosed by US were diagnosed correctly by MRI. Conclusions: AIP in suspected cases can be detected with the use of ultrasound examination with high efficiency by experienced specialists. Diagnostic value is not increased with the use of MRI in this study.