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Placenta Accreta and Percreta: Sonographic, MRI, and Surgical Correlation

Placenta Accreta and Percreta: Sonographic, MRI, and Surgical Correlation

Magnetic Resonance Imaging Figures 1 through 22

by  José M Palacios Jaraquemada MD Ph. D 
University of Buenos Aires, School of Medicine, First Anatomy Chair; Fundación Científica del
Sur and Durand Hospital, Obgyn Department.
Buenos Aires, Argentina
obstetrics@hotmail.com or jpalacios@ciudad.com.ar 

Citation: Palacios JM, Lapidus A; Placenta Accreta and Percreta: Sonographic, MRI, and Surgical Correlation; April 2001; 
http://www.obgyn.net/us/placenta-accreta/placenta-accreta-imagesMRI.htm

Click images for larger view in a pop-up window

Placenta MR Imaging (MRI Figure 1 A ST)

Description of the image: Axial STIR cut: The MRI showed in detail the newly formed vessel invasion to the bladder.

 


Placenta MR Imaging (MRI Figure 1 S SE Co )

Description of the image: Sagittal cut: Notice you the correct repair of the wall previous uterine three months after the surgery for placenta percreta with bladder invasion.

 


Placenta MR Imaging (MRI Figure 1 S ST)

Description of the image: Sagittal Cut, STIR Technique: One can see the vascular invasion clearly to the vesical muscle.

 


Placenta MR Imaging (MRI Figure 2 A SE )

Description of the image: Axial cut: The placenta percreta invades the lateral wall of the uterus and additionally the parametrium.

 


Placenta MR Imaging (MRI Figure 2 S SE c)

Description of the image: Sagittal cut: Uterine appearance after 3 months repair surgery by placenta percreta with bladder invasion. See the harmless anterior uterine wall.

 


Placenta MR Imaging (MRI Figure 2 S ST)

Description of the image: Sagittal Cut: Eighteen-week pregnancy. Echography diagnosis: Cervical pregnancy.
Surgery at twenty-eighth week, massive anterior placenta percreta with parametrium and pelvic invasion.
Procedure: Aortic vascular control, total abdominal hysterectomy with ovary conservation
Newborn weight: 800 g. discharge three months later without problems.

 


Placenta MR Imaging (MRI Figure A 3 SE)

Description of the image: Sagittal Cut: Four cesarean sections plus total placenta previa. The MRI showed a partial placenta increta and percreta in the posterior wall of the bladder.

 


Placenta MR Imaging (MRI Figure C 1 SE)

Description of the image: Coronal Cut: The destruction image is wide and it corresponds to a placenta percreta with parametrial invasion

 


Placenta MR Imaging (MRI Figure 1 S ST)

Description of the image: Sagittal Cut, STIR Technique: One can see the vascular invasion clearly to the vesical muscle.

 


Placenta MR Imaging (MRI Figure C 1 ST)

Description of the image: Coronal Cut STIR Technique: The newly formed vessels infiltrate the vesical muscle clearly from the placenta

 


Placenta MR Imaging (MRI Figure C 2 SE)

Description of the image: Coronal Cut: Bladder massive invasion by placenta percreta. In detail the MRI showed the muscles lost in the bladder surface.

 


Placenta MR Imaging (MRI Figure C 3 SE)

Description of the image: Coronal cut: Placenta percreta with vesical invasion. The uterine segment this totally destroyed one.

 


Placenta MR Imaging (MRI Figure C 4 SE G)

Description of the image: Coronal Cut with gadolinium: The invasion of the bladder with multiple newly formed vessels is characteristic of placenta percreta

 


Placenta MR Imaging (MRI Figure C 5 SE G)

Description of the image: Coronal cut: In detail the newly formed vessels into the bladder surface.

 


Placenta MR Imaging (MRI Figure C 6 SE G)

Description of the image: Coronal cut. Exuberant invasion in patient with two previous cesarean section. The MRI showed a multiples layers of abnormal uteroplacental vessels.
Surgery: At 34.1 weeks: Total abdominal hysterectomy with ovary conservation and bladder repair.

 


Placenta MR Imaging (MRI Figure N 7 C)

Description of the image: Coronal Cut: Ultrasound to showed some characteristics of placenta accreta. However, the MRI shows the normal interface between placenta and uterus

 


Placenta MR Imaging (MRI Figure C 8 SE G)

Description of the image: Coronal cut: Twenty two year old patient, two previous cesarean sections. In five echographic informed: anterior placenta accreta in the previous hysterotomy place. At week thirty three the patient developed a one episode of hematuria and the doctor requested a MRI diagnosis.
Surgery: At thirty five weeks, anterior placenta percreta with bladder invasion. Aortic vascular control, uterine and bladder repair.

 


Placenta MR Imaging (MRI Figure N 1 C)

Description of the image: Coronal cut, patient with initial diagnosis of cervical pregnancy. In detail, parametrial placentary invasion.

 


Placentary MR Imaging (MRI Figure N 2 S)

Description of the image: Sagittal cut: Ultrasound positive for placenta accreta. However the MRI shows a correct separation line and a discreet retroplacentary hematoma

 


Placentary MR Imaging (MRI Figure S 1 SE )

Description of the image: Sagittal cut: The full one partial of the bladder it allows the best image in the placenta percreta

 


Placentary MR Imaging (MRI Figure S 2 SE)

Description of the image: Sagittal cut: Total occlusive placenta previa, five previous cesarean sections. Microscopic hematuria, alpha feto protein 6 multiples of media. Echography: Turbulent blood flow within the placenta or at the uteroplacental junction.
Surgery at week 35: Massive anterior placenta percreta.
Aortic vascular control, bladder repair and uterine conservation

 


Placentary MR Imaging (MRI Figure S 3 G)

Description of the image: Sagittal Cut: Tenth cesarean section, low education patient, with an echographic study showed: Large vascular collections appeared as sonolucent spaces throughout the placenta. No limits between myometrium and bladder.
Surgery: At week 35, Massive anterior placenta percreta and cervical placenta accreta. Procedure: aortic vascular control, fundal hysterotomy. Bladder and uterine repair. Newborn with minor respiratory distress.

 


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