Correlation of imaging features and histop athoiogy in postpartum placental accrete
Objective: To investigate the features and diagnostic value of MRI and CT in postpartum placenta accreta(PA). Materials and Methods: Fourteen cases PA comfirmed clinically or pathologically were retrospectively analyzed(aged 24—39 years old, with an average of 30.6±2.5 years old). Ten cases were examined by MRI scans, four cases by conventional and contrast-enhanced CT scans, their imaging appearances were analysed. Results: Fourteen cases were correctly diagnosed with MRI and CT. Uterus enlarged in various degrees, the mixed signal intensity mass was showed in it. The integrity of endometrium and junctional zone of myometrium was destructed. Placentas of shorter gestational age appeared to be a mixed simple mass, the longer ones to be lobulated structure distinctively. Compared with the signal intensity of the outer layer of the myometrium, the signal intensity of implanted placenta showed isointense or hypointense and its boundary with uterus was not clear on T1 WI. On T2 WI, it showed significantly mixed hyperintense, and spread strip and punctate low signal shadows. The lesions invaded myometrium, and made the myometrium thinning locally. The lesions invaded close to perimetrium in 3 cases. By CT scan, they showed a ill-defi ned low density, by enhancement scan, placentas were heterogeneous enhancement significantly, appeared to bepetal shaped, similar to enriched degree of myometrium. The necrotic area were not enhanced, depicted ascrack shaped. Conclusion: Compared with CT, MRI can make correct diagnosis of PA and judge the general degree of placental invasion, as similar with pathologic types. It is a kind of auxiliary diagnostic tool ideally.