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CT angiography for characterization of advanced placenta accreta spectrum: indications, risks, and benefits

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A Commentary to this article was published on 10 January 2024

Abstract

Placenta accreta spectrum disorder (PASD) encompasses various types of abnormal placentation in which chorionic villi directly adhere to or invade the myometrium. The incidence of PASD has dramatically risen in the US over the past 3 decades owing to the increased rates of patients undergoing cesarean sections. While PASD remains a significant cause of maternal morbidity and mortality, accurate prenatal identification and characterization of PASD is associated with improved outcomes. Although ultrasound is the first-line imaging modality in the evaluation of PASD, with MRI serving as an adjunct, computed tomography angiography (CTA) may also offer unique diagnostic advantages in cases of advanced PASD by providing superior visualization of placental and abdominopelvic vasculature and enabling the creation of comprehensive vascular maps to roadmap complex surgical interventions. This paper represents the first evaluation of CTA as a diagnostic tool and operative planning aid in this context. Appropriate indications and diagnostic advantages of CTA in this setting are reviewed, and key multimodal imaging features of normal and abnormal placentation are highlighted.

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Authors and Affiliations

  1. Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, JHOC 3150, 601 N Caroline St, Baltimore, MD, 21287, USA

    Erin N. Gomez, Taha M. Ahmed, Katarzyna Macura & Elliot K. Fishman

  2. Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA

    Arthur J. Vaught

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Gomez, E.N., Ahmed, T.M., Macura, K. et al. CT angiography for characterization of advanced placenta accreta spectrum: indications, risks, and benefits. Abdom Radiol 49, 842–854 (2024). https://doi.org/10.1007/s00261-023-04105-7

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  • DOI: https://doi.org/10.1007/s00261-023-04105-7

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