Magnetic resonance imaging of the female pelvis after Cesarean section: a pictorial review

Bekiesińska‐Figatowska, Monika

doi:10.1186/s13244-020-00876-5

Cited by 4 publications

(1 citation statement)

References 29 publications

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“…Compared to ultrasound, MRI provides more comprehensive anatomical insights into the pelvis, and has a higher tissue resolution and a wider field of vision. It can not only display the relative positions of the uterus, placenta, and cervix, but can also display the structure of the surrounding pelvic organs, such as the bladder, vagina, and rectum ( 11 , 12 ).…”

Section: Discussionmentioning

confidence: 99%

Anterior uterine incarceration complicated by placenta previa and placenta accreta spectrum disorder: a case report

Lian¹,

Zhang²,

Xu³

et al. 2023

Ann Transl Med

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Background: Uterine incarceration is a rare obstetric complication that is always associated with retroversion and prone to misdiagnosis. Pelvic examination and imaging methods including ultrasound and magnetic resonance imaging (MRI) are used as the primary diagnostic tool. We present an asymptomatic anterior uterine incarceration complicated by placenta previa and placenta accreta spectrum (PAS) disorder, which could be diagnosed during the pregnancy periods, but was first diagnosed during the cesarean section (CS) and got the surgeons into trouble.Case Description: A 28-year-old woman, gravidity 4, parity 1, was hospitalized due to placenta previa and PAS disorder diagnosed by ultrasound and MRI at 35.6 weeks of gestation. She had not experienced any discomfort. Given her history of a previous CS, she underwent a well-prepared cesarean delivery for the termination of the pregnancy. The patient had a series of periodical ultrasound and MRI examinations in which placenta previa and placenta accreta were described in disregard of the abnormal location of cervix; consequently, interior uterine incarceration was first diagnosed during the surgery, which caused significant difficulties in the operation which lasted 3 hours and 21 minutes. The patient developed severe hemorrhaging and lost approximately 5,000 mL of blood. Fortunately, she delivered a health male infant weighing 3,440 grams with quite good Apgar scores. During the follow-up, maternal and child health was confirmed.Conclusions: With regard to patients who have undergone previous pelvic surgery, doctors need to pay close attention to the position of the cervix, the pelvic adhesion situation during the prenatal examination, and be on alert for uterine incarceration. Uterine incarceration can be accurately recognized by periodic sonography and MRI if the radiologist is aware of this unusual condition. We do suggest that special are must be taken to avoid unnecessary trauma by misdiagnosis because of lack of awareness.

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Section: Discussionmentioning

confidence: 99%

Anterior uterine incarceration complicated by placenta previa and placenta accreta spectrum disorder: a case report

Lian¹,

Zhang²,

Xu³

et al. 2023

Ann Transl Med

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Caesarean-section scar endometriosis (CSSE): clinical and imaging fundamentals of an underestimated entity

Arkoudis¹,

Moschovaki-Zeiger²,

Prountzos³

et al. 2023

Clinical Radiology

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Endometriosis MR mimickers: T2-hypointense lesions

Ruaux,

VanBuren,

Nougaret

et al. 2024

Insights Imaging

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Endometriosis is a common crippling disease in women of reproductive age. Magnetic resonance imaging (MRI) is considered the cornerstone radiological technique for both the diagnosis and management of endometriosis. While its sensitivity, especially in deep infiltrating endometriosis, is superior to that of ultrasonography, many sources of false-positive results exist, leading to a lack of specificity. Hypointense lesions or pseudo-lesions on T2-weighted images include anatomical variants, fibrous connective tissues, benign and malignant tumors, feces, surgical materials, and post treatment scars which may mimic deep pelvic infiltrating endometriosis. False positives can have a major impact on patient management, from diagnosis to medical or surgical treatment. This educational review aims to help the radiologist acknowledge MRI criteria, pitfalls, and the differential diagnosis of deep pelvic infiltrating endometriosis to reduce false-positive results.Critical relevance statementMRI in deep infiltrating endometriosis has a 23% false-positive rate, leading to misdiagnosis. T2-hypointense lesions primarily result from anatomical variations, fibrous connective tissue, benign and malignant tumors, feces, surgical material, and post-treatment scars.Key points• MRI in DIE has a 23% false-positive rate, leading to potential misdiagnosis.• Anatomical variations, fibrous connective tissues, neoplasms, and surgical alterations are the main sources of T2-hypointense mimickers.• Multisequence interpretation, morphologic assessment, and precise anatomic localization are crucial to prevent overdiagnosis.• Gadolinium injection is beneficial for assessing endometriosis differential diagnosis only in specific conditions. Graphical Abstract

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Magnetic resonance imaging of the female pelvis after Cesarean section: a pictorial review

Cited by 4 publications

References 29 publications

Anterior uterine incarceration complicated by placenta previa and placenta accreta spectrum disorder: a case report

Anterior uterine incarceration complicated by placenta previa and placenta accreta spectrum disorder: a case report

Caesarean-section scar endometriosis (CSSE): clinical and imaging fundamentals of an underestimated entity

Endometriosis MR mimickers: T2-hypointense lesions

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