Evaluate for placenta accreta. History of sickle cell disease. Please note that this study was not performed for fetal assessment.PELVIS:UTERUS, ADNEXA: Gravid uterus. Anterior uterus implantation.On today's study the uterus is more than 2 cm away from the internal cervical os. Redemonstrated are hypointense T2 bands within the myometrium compatible with placenta accreta/increta. In addition demonstrated again is poor delineation of the left anterior uterine wall and the adjacent inner surface of the rectus muscle concerning for placenta percreta. Additionally there is a nodular density in the posterior dome of the bladder (series 10 image 15) which although may be artifactual appears to have been present on the prior study and may represent placenta percreta into the bladder.BLADDER: See discussion above.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right-sided hydroureteronephrosis, likely physiologic given gravid state.Osseous stigmata of sickle cell disease and possible mild avascular necrosis of the femoral heads.OTHER: No significant abnormality noted.
1.Again the left anterior uterine wall is inseparable from the underlying left rectus muscle and remains suspicious for placenta percreta appearing similar to the prior study. 2.There is also concern for placenta percreta involving the posterior dome of the urinary bladder where there is a persistent nodular focus of signal abnormality.3.Correlation with ultrasound findings which are not available for comparison is recommended. 