Comparison of scar thickness measurements using trans-vaginal sonography and MRI in cases of pregnancy with previous caesarean section. Do they correlate with actual scar thickness?

Abstract

The aim of this study was to evaluate scar thickness in cases of pregnancy with previous caesarean section, by trans-vaginal sonography (TVS) and magnetic resonance imaging (MRI), and to correlate precision of radiologically-measured scar thickness with actual measurement of scar thickness. A total of 35 pregnant patients with previous caesarean section planned for elective caesarean section, were evaluated prospectively. Their scar thickness was measured by TVS and MRI on the day of elective repeat caesarean section. These measurements were correlated with each other and with scar thickness measured during elective repeat caesarean section by using a caliper. The correlation coefficients between scar thickness measured by TVS and MRI with peroperative evaluation with a caliper, were +0.72 and +0.59, respectively. The study concluded that as MRI is a costlier modality and TVS has better correlation coefficient with actual scar thickness, TVS can be considered to be the better modality for antenatal scar thickness measurement.

Comparison of the lower uterine segment in pregnant women with and without previous cesarean section in 3 T MRI

“…With fast T2-weighted sequences, relevant uterine structures and particularly the very thin LUS can be reliably visualized, independent of ultrasound limitations. Due to the higher field strength of 3 T, spatial resolution and tissue contrasts were better in our study than those in previous studies using 1.5 T [11, 12]. Consistent with previous studies, our data indicate that urinary bladder filling level does not influence LUS thickness, and thus, a partial filling level might be preferred for better patient comfort [8].…”

“…However, the abovementioned histological alterations cannot be depicted using T2-weighted sequences. Because of the strong individual heterogeneity of LUS morphology, we furthermore do not think that T2-weighted MRI or ultrasound-derived tissue characteristics are appropriate for risk stratification as previously suggested [12, 13]. As suggested by small feasibility studies ultrasound-elastography or advanced MRI sequences such as diffusion tensor imaging (DTI) might be more suitable for scar tissue characterization after CS [26, 27].…”

Cesarean section scar diverticulum evaluation by saline contrast‐enhanced magnetic resonance imaging: The relationship between variable parameters and longer menstrual bleeding

“…Another study investigated the accuracy of ultrasound and MRI for measuring the thickness of previous CS scars on the day of selective CS compared with the actual size of the CS muscular layer. No significant difference between TVU and MRI was observed, but this study focused on term pregnant women with a history of CS, not women with CSD . In our study, 282 patients who presented with prolonged menstrual bleeding were enrolled, and the measurements of CSD obtained by TVU, general MRI and CE‐MRI were compared.…”

Magnetic resonance imaging as additional diagnostic tool in assessment of lower uterine segment in women with previous Cesarean section

“…Currently, magnetic resonance imaging (MRI) is not part of any published algorithm for uterine rupture risk assessment, and study data on its use for this purpose are still insufficient. To date, neither reliability of MRI assessment of LUS wall thickness nor detailed description of normal anatomy and morphology has been reported,.…”

“…In our department, we have gained good experience with the use of 3‐Tesla (T) MRI (MAGNETOM Trio, Siemens Healthcare, Erlangen, Germany) for assessment of LUS. It provides accurate tissue characterization, independent of patient BMI, and is a safe alternative imaging modality during pregnancy,. We use a protocol with a standard T2‐weighted half‐Fourier acquisition single‐shot turbo spin echo (HASTE) sequence (slice thickness, 4 mm; repetition time, 1500 ms; echo time, 95 ms; matrix, 320 × 320) and a turbo spin echo (TSE) sequence (slice thickness, 3 mm; repetition time, 4110 ms; echo time, 126 ms; matrix, 192 × 192) in a sagittal orientation.…”