Value of contrast-enhanced ultrasound in diagnosis of placental increta

Abstract

Objective To evaluate the value of contrast-enhanced ultrasound(CEUS) in diagnosis of placental increta.Methods Twenty seven suspected patients with placental increta were examined with CEUS after routine ultrasound examination.SonoVue was injected intravenously as bolus and a real time CEUS was performed.The characteristics of contrast perfusion was analysised.Results Among the three antepartum CEUS cases,two had a clear boundary between the placenta and uterine wall,there was no residual placenta after induced labor;one had a blur boundary between the local placenta and uterine wail,and the local placenta adherenced to the uterine wall tightly when cesarean section was performed after induction failure.Comparison between CEUS and uterine curettage in 20 cases,5 cases had a dear boundary between residual disease in uterine cavity and uterine wall.The boundary between residual disease in uterine cavity and uterine wall disappeared in other 15 cases.Four cases performed total and subtotal hysterectomy,the uterine myometrium of placenta affixing part were very thin (3 - 5 mm),and the boundary between the placenta and uterine wall disappeared,and placental increta was proved by intraoperative and pathology.Conclusions When the boundary between residual placenta and uterine wall disappeared and/or the local uterine wall became thin,placental increta was suggested intensively. Key words: Ultrasonography; Microbubbles; Placenta; Placenta accreta