LAUSR

This study aimed to compare the diagnostic accuracy of ultrasound (US) and magnetic resonance imaging (MRI) in the detection of placenta accreta spectrum (PAS) disorders in a single tertiary care setting. All eligible participants prospectively underwent both US and MRI examinations prior to delivery at our institution. Two experienced radiologists independently interpreted both the US and MRI findings. The interobserver agreement was assessed using the intraclass correlation coefficient (ICC) in a subset of twenty randomly selected participants. The diagnostic performance of each imaging modality was evaluated against the gold standard of surgical or pathological findings. In a cohort of 131 pregnancies, the diagnostic performance of MRI and US was found to be comparable, with an accuracy (ACC) of 0.718 for MRI and 0.702 for US, respectively. In the subgroup of placental accrete cases, MRI demonstrated modestly higher performance than US (p = 0.023), while in the normal, increta, or percreta groups, the performance was equivalent. The ICC for both MRI and US was moderate, with values of 0.663 and 0.600, respectively. The most common causes of misdiagnosis for US were challenging patient positioning for US acquisition, thickened placenta, and prior cesarean section surgery. For MRI, the primary reason was the morphological changes occurring between the time of scanning and delivery. Our findings indicate that MRI provides incremental value in the assessment of suspected placental accrete cases. Overall, MRI and US showed equivalent diagnostic performance for the confirmation of PAS disorders.