Cesarean section scar in 3 T magnetic resonance imaging and ultrasound: image characteristics and comparison of the methods
| Autor: | Holger Stepan, M Exner, Matthias Grothoff, Janine Hoffmann, Patrick Stumpp, Kristina Bremicker, Susanne Schrey-Petersen |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Image quality Prenatal diagnosis Asymptomatic 030218 nuclear medicine & medical imaging 03 medical and health sciences Cicatrix 0302 clinical medicine Uterine Rupture Pregnancy Medicine Humans Prospective Studies Ultrasonography 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Orientation (computer vision) Cesarean Section Ultrasound Obstetrics and Gynecology Magnetic resonance imaging General Medicine medicine.disease Magnetic Resonance Imaging Sagittal plane Uterine rupture medicine.anatomical_structure Female medicine.symptom business Nuclear medicine |
| Zdroj: | Archives of gynecology and obstetrics. 299(2) |
| ISSN: | 1432-0711 |
| Popis: | Uterine rupture during labor is a rare but life-threatening complication after previous cesarean section (CS). Prenatal risk is assessed using ultrasound thickness measurement of the lower uterine segment (LUS). Due to inhomogeneous study results, however, clinical obstetrics still lacks for standard protocols and reliable reference values. As 3 T magnetic resonance imaging (MRI) has not yet been sufficiently studied regarding LUS diagnostics after previous CS, we sought to evaluate its feasibility focusing on thickness measurements and typical characteristics of the CS-scar region in comparison to ultrasound and the intraoperative status. In this prospective study, 25 asymptomatic patients with one previous CS and inconspicuous ultrasound findings were included. An additional 3 T MRI with either a T2-weighted Turbo-Spin-Echo or a Half Fourier-Acquired-Single-shot-Turbo-spin-Echo sequence in a sagittal orientation was performed. We analyzed categorical image quality, inter- and intra-rater reliability as well as anatomy, morphology and thickness of the LUS. Results were compared to ultrasound and intraoperative findings. MRI provided good to excellent image quality in all patients. The imaged structures presented with a high variability in anatomy and morphology. Image characteristics indicating the uterine scar were only found in 11/25 (44%) patients. LUS thickness measurements with MRI showed good inter- and intra-rater reliability but poor agreement with ultrasound. MRI is appropriate for additional LUS diagnostics in patients with previous CS. The strong individual variability of LUS-anatomy and morphology might explain the difficulties in establishing uniform diagnostic standards after CS. |
| Databáze: | OpenAIRE |
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