Ultrasound vs. Magnetic Resonance Imaging in the Diagnosis of Placenta Accreta Spectrum

PAS (Placenta Accreta Spectrum) is a rare, multifactorial, life-threatening condition for both the mother and the fetus, posing a diagnostic challenge for both expert and non-expert sonographers during the clinical monitoring of pregnancy. The aim of this work is to assess the prenatal diagnostic predictability of placenta accreta spectrum comparing two methods: ultrasound and magnetic resonance imaging. A prospective comparison was done over a 4-year period (2019–2022) between US and MRI diagnostic recognitions of PAS. Thirty-four cases prenatally were diagnosed by US аnd confirmed pathohistologically with complete agreement. Comparative diagnostic recognition was performed in 74 cases suspected for placenta praevia accreta by US, in 35 cases PAS were found, and 39 were excluded as normal placenta praevia. In 41 of all 74 cases, MRI was additionally performed. The US has done by one expert and the following markers for PAS were examined: loss of clear space, abnormal lacunae, subplacental hypervascularity, and bridging vessels. MRI diagnosis following standard protocols from more than one expert was made. The presented observation period was part of an 11-year prospective study (2012–2023) covering 61 cases of clinically and pathohistologically confirmed PAS. The results showed that MRI has a recognizability rate of 67.62% compared to ultrasound, which showed a 97.14% coincidence. The US methodology has significance detecting PAS and was primarily performed by one expert (p