Three-dimensional sonography of placental mesenchymal dysplasia and its differential diagnosis

Edi Vaisbuch, Roberto Romero, Juan Pedro Kusanovic, Offer Erez, Shali Mazaki-Tovi, Francesca Gotsch, Jai Kim Chong, Jung Sun Kim, Lami Yeo, Sonia S. Hassan

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Objective. Placental mesenchymal dysplasia (PMD) is an uncommon vascular anomaly of the placenta characterized by mesenchymal stem villous hyperplasia. Its main sonographic feature is a thickened placenta with hypoechoic areas, and an accurate sonographic diagnosis is challenging. The aim of this study was to report 2 cases of PMD and discuss the differential diagnosis of its sonographic features. Methods. Cases of placental masses were studied by 2-dimensional (2D), 3-dimensional (3D), and color Doppler imaging. Results. In case 1, a thick placenta with multiple hypoechoic areas was noted at 13 weeks' gestation. At 19 weeks, the multicystic area, clearly demarcated from a normal-looking placenta, measured 6.5 x 8.5 cm and enlarged gradually. The patient gave birth to a 625-g female neonate after spontaneous labor at almost 26 weeks' gestation. In case 2, a first sonographic examination at 25 weeks' gestation revealed a thickened placenta with hypoechoic areas and a fetus with a single umbilical artery and a ventricular septal defect. At 27 weeks, the abnormal area of the placenta measured 14.5 x 7.5 cm. At 32 weeks' gestation, a caesarean delivery was performed because of a nonreassuring fetal heart tracing, and a 1415-g female neonate was delivered. Both cases were evaluated by 2D, 3D, and color Doppler imaging, and the pathologic features of both placentas were consistent with PMD. Conclusions. Placental mesenchymal dysplasia should be considered in the differential diagnosis of every placental mass, especially in cases of multicystic placental lesion with lack of high-velocity signals inside the lesion, and a normal karyotype.

Original languageEnglish
Pages (from-to)359-368
Number of pages10
JournalJournal of Ultrasound in Medicine
Issue number3
StatePublished - 1 Mar 2009
Externally publishedYes


  • Chorioangioma
  • Complete hydatidiform mole and coexistent fetus
  • Doppler sonography
  • Mesenchymal hyperplasia
  • Pseudo partial mole
  • Sonography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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