Skip to main content
SpringerLink
Log in

Postpartum MR diagnosis of retained placenta accreta

  • Urogenital
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Retained placenta accreta can cause catastrophic postpartum hemorrhage. This study aims to determine whether MR imaging can differentiate retained placenta accreta from postpartum hemorrhage caused by other conditions. Fourteen cases suspicious for retained placenta were examined with MR imaging. Signal intensity, the enhancing pattern of uterine contents, and flow voids within the myometrium were retrospectively studied. As hysterectomy was performed in only two cases, final diagnosis was based on clinical outcome and analysis of uterine contents. Final diagnoses were retained placenta accreta in seven cases, retained normally attached placenta in four, hematoma in two, and placental site trophoblastic tumor (PSTT) in one. All seven cases with placenta accreta had a very hyperintense area on T2-weighted images, showing transient early enhancement. None demonstrated delayed strong enhancement around the hyperintense area. In two cases with retained normally attached placenta and in both with hematomas, there were no hyperintense areas on T2-weighted images. Of these, only one showed transient early enhancement. Flow voids were observed in four cases with placenta accreta, one with normally attached placenta, and the case with PSTT. A markedly hyperintense area on T2-weighted images and transient early enhancement without delayed strong enhancement between the mass and the myometrium can indicate retained placenta accreta.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1a–d
Fig. 2a–c
Fig. 3a–c
Fig. 4a–c
Fig. 5a–d

Similar content being viewed by others

References

  1. Cunningham FG, MacDonald PC, Gant NF, Leveno KJ, Gilstrap LC III, Hankins GDV, Clark SL (1997) Disease and abnormality of the placenta. In: Williams Obstetrics, 20th edn. Appleton and Lange, Norwalk

  2. Tanaka YO, Sohda S, Shigemitsu S, Niitsu M, Itai Y (2001) High temporal resolution dynamic contrast MRI in a high risk group for placenta accreta. Magn Reson Imaging 19:635–642

    Article  CAS  PubMed  Google Scholar 

  3. Levine D, Hulka CA, Ludmir J, Li W, Edelman RR (1997) Placenta accreta: evaluation with color Doppler US, power Doppler US, and MR imaging. Radiology 205:773–776

    PubMed  Google Scholar 

  4. Kim H, Hill MC, Winick AB, Shen T (1998) Residents’ teaching files. Prenatal diagnosis of placenta accreta with pathologic correlation. Radiographics 18:237–242

    CAS  PubMed  Google Scholar 

  5. Ha TP, Li KC (1998) Placenta accreta: MRI antenatal diagnosis and surgical correlation. J Magn Reson Imaging 8:748–750

    CAS  PubMed  Google Scholar 

  6. Marcos HB, Semelka RC, Worawattanakul S (1997) Normal placenta: gadolinium-enhanced dynamic MR imaging. Radiology 205:493–496

    CAS  PubMed  Google Scholar 

  7. Entel RJ, Kane JA, Weiss BR (1998) Postpartum magnetic resonance imaging in a case of placenta accreta with intrauterine abscess formation. Arch Gynecol Obstet 262:91–94

    CAS  PubMed  Google Scholar 

  8. Miyata M, Yoshioka K, Ehara S, Tamakawa Y, Sato T, Kagabu T (1998) MR findings of placenta accreta: a report of four cases. Jpn J Magn Reson Med 18:440–445

    Google Scholar 

  9. Amoh Y, Watanabe Y, Saga T, Dohke M, Sato N, Mitsudo K, Nakahori T, Ukita M (1995) Retained placenta accreta: MRI and pathologic correlation. J Comput Assist Tomogr 19:827–829

    Google Scholar 

  10. Neish AS, Frates MC, Tempany CM (1995) Placenta percreta post evacuation: an unusual uterine mass on MRI. J Comput Assist Tomogr 19:824–827

    Google Scholar 

  11. Noonan JB, Coakley FV, Qayyum A, Yeh BM, Wu L, Chen LM (2003) MR imaging of retained products of conception. Am J Roentgenol 181:435–439

    Google Scholar 

  12. Preidler KW, Luschin G, Tamussino K, Szolar DM, Stiskal M, Ebner F (1996) Magnetic resonance imaging in patients with gestational trophoblastic disease. Invest Radiol 31:492–496

    Article  CAS  PubMed  Google Scholar 

  13. Huang MW, Muradali D, Thurston WA, Burns PN, Wilson SR (1998) Uterine arteriovenous malformations: gray-scale and Doppler US features with MR imaging correlation. Radiology 206:115–123

    CAS  PubMed  Google Scholar 

  14. Kido A, Togashi K, Koyama T, Ito H, Tatsumi K, Fujii S, Konishi J (2003) Retained products of conception masquerading as acquired arteriovenous malformation. J Comput Assist Tomogr 27:88–92

    Google Scholar 

  15. Brandt KR, Coakley KJ (1998) MR appearance of placental site trophoblastic tumor: a report of three cases. Am J Roentgenol 170:485–487

    CAS  Google Scholar 

  16. Silverberg SG, Kurman RJ (1992) Tumors of uterine corpus and gestational trophoblastic disease. Armed Forces Institute of Pathology, Washington DC

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Yumiko Oishi Tanaka & Yuji Itai

  2. Department of Obstetrics and Gynecology, Ryugasaki Saiseikai General Hospital, Ryagasaki, Japan

    Sadahiko Shigemitsu

  3. Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Yoshihito Ichikawa, Satoshi Sohda & Hiroyuki Yoshikawa

Authors
  1. Yumiko Oishi Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sadahiko Shigemitsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshihito Ichikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Satoshi Sohda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hiroyuki Yoshikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yuji Itai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yumiko Oishi Tanaka.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tanaka, Y.O., Shigemitsu, S., Ichikawa, Y. et al. Postpartum MR diagnosis of retained placenta accreta. Eur Radiol 14, 945–952 (2004). https://doi.org/10.1007/s00330-004-2266-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-004-2266-8

Keywords

Search

Navigation