Ultrasound versus magnetic resonance imaging features in diagnosing placenta accreta: A systematic review and...

The purpose of this study is to conduct a complete analysis of the accuracy of ultrasound and MRI in detecting placenta accreta spectrum (PAS) disorders, as well as to investigate the accuracy of independent imaging findings in these diseases.

Pubmed, Web of Science, Embase, The Cochrane Library, and Google Scholar databases were searched from their establishment to January 1, 2025. Included were all studies that used both ultrasonography and MRI to diagnose pregnant women with PAS disorder. The ability of ultrasonography, MRI, and their independent features to diagnose PAS was evaluated using pooled sensitivity, specificity, diagnostic odds ratio (DOR), and receiver operating curves (ROC). Heterogeneity was calculated using Cochran Q and I² statistics, and the sources of heterogeneity were investigated using meta-regression and subgroup analysis.

Following a series of rigorous assessments, the meta-analysis comprised 1989 pregnant women from 30 studies. The sensitivity and specificity of ultrasonography for the diagnosis of PAS were 0.87 (95 % CI, 0.82-0.90) and 0.83 (95 % CI, 0.77-0.88), respectively, whereas the sensitivity and specificity of MRI for the same diagnostic were 0.87 (95 % CI, 0.82-0.90) and 0.84 (95 % CI, 0.80-0.88). Intraplacental lacunae has the best diagnostic accuracy of ultrasound, while placental bulge has the highest diagnostic accuracy of MRI, with their area under the curve (AUC) of the ROC being 0.76 (95 % CI, 0.72-0.79) and 0.89 (95 % CI, 0.85-0.91), respectively.

The diagnostic accuracy of ultrasound and MRI for PAS was similar. However, radiographic findings should not be utilized to make an independent diagnosis of PAS disorders.