Feasibility of diffusion-weighted MRI for defining placental invasion

The purpose of this clinical note is to describe the feasibility of using diffusion-weighted imaging for diagnosing placental invasion with a case of placenta increta and six cases without it. Diffusion-weighted imaging (DWI) at a b-value of 1000 sec/mm(2) can clearly define the border between the placenta and myometrium because only the placenta shows very high signal intensity. The corresponding image at a b-value of 0 sec/mm(2) shows the myometrium with high signal intensity compared with the surrounding fat. Therefore, fusion of the two images can be used additionally to visualize thickness of the myometrium. As a result, DWI can be used to visualize the focal thinning of the myometrium caused by placenta increta, which has been difficult to diagnose on conventional magnetic resonance imaging sequences without contrast enhancement. However, the use of DWI for placental invasion should be determined following careful consideration of its risks and benefits, as fetus safety has not been established.