Comparative Diagnostic Accuracy of Ultrasonography and Magnetic Resonance Imaging in Placenta Accreta Spectrum

Abstract

Introduction: Placenta accreta spectrum (PAS) is a serious obstetric condition associated with significant maternal morbidity and mortality, particularly in resource-limited settings such as India. Early and accurate antenatal diagnosis is crucial for optimal management and significant reduction of obstetric complications. Aim: The aim of the study was to compare the diagnostic accuracy of ultrasonography (USG) and magnetic resonance imaging (MRI) in detecting PAS using histopathology as the gold standard. Materials and Methods: This prospective observational study included 30 pregnant women with suspected PAS. All patients underwent USG followed by MRI, and findings were correlated with histopathological examination results. Diagnostic performance parameters were calculated. Results: Out of 30 patients, PAS was confirmed in 26 cases. USG demonstrated a sensitivity of 73.08% and specificity of 25%, with an overall diagnostic accuracy of 66.67%. MRI showed higher sensitivity (92.31%) and specificity (75%), with superior diagnostic accuracy of 90%. MRI also showed better delineation of placental invasion, particularly in cases with posterior placenta and inconclusive USG findings. Conclusion: MRI demonstrates superior diagnostic performance compared to USG in the evaluation of PAS. While USG remains an effective first-line screening tool in resource limited setting such as India, MRI serves as a valuable adjunct in high-risk or equivocal cases, improving diagnostic confidence and aiding in preoperative planning.