Advanced MRI Mapping Using Diffusion-Weighted and T2 HASTE Sequences in Placenta Accreta Spectrum Disorders: Histopathological and Surgical Correlation Analysis

Abstract

Background: Placenta accreta spectrum (PAS) disorders are life-threatening conditions characterized by abnormal placental attachment. Early diagnosis is essential for effective surgical management. Objective: To evaluate the utility of advanced MRI mapping using diffusion-weighted (DWI) and T2 HASTE sequences for the diagnosis of PAS disorders and correlate these findings with histopathological and surgical outcomes. Methods: This study was conducted at the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, between January 2020 and June 2022. A total of 194 patients with suspected PAS disorders underwent MRI using DWI and T2 HASTE sequences. Histopathological confirmation was obtained post-delivery. Data analysis included the calculation of sensitivity, specificity, and p-values to assess the diagnostic accuracy of MRI in detecting placental invasion. Statistical analysis was performed using SPSS version 26.0, and the results were evaluated using standard deviation and p-value metrics. Results: Of the 194 patients, 152 (78.4%) were diagnosed with PAS disorders. The sensitivity of DWI for detecting placental invasion was 88%, while T2 HASTE demonstrated 85% sensitivity. The specificity was 92% for DWI and 90% for T2 HASTE. The correlation between MRI findings and histopathology was highly significant (p < 0.001). The mean standard deviation for DWI and T2 HASTE imaging was 5.5 and 6.2, respectively. Surgical outcomes indicated that 30% of patients required hysterectomy, with significant p-values (<0.05) correlating the depth of placental invasion and the need for surgical intervention. Conclusion: Advanced MRI mapping with DWI and T2 HASTE sequences offers high diagnostic accuracy and is a valuable tool in the management of PAS disorders.