Application value of transvaginal ultrasound combined appropriately magnetic resonance imaging in cesarean scar diverticulum

Abstract

Objective \nTo evaluate application value of transvaginal ultrasound (TVU) properly combined magnetic resonance imaging (MRI) in cesarean scar diverticulum (CSD). \n \n \nMethods \nFrom January 2014 to February 2016, 199 patients underwent vaginal Repair of CSD in Shanghai First Maternity and infant Hospital, Tongji University School of Medicine. Imaging features of ultrasound and magnetic resonance of these patients were retrospectively analyzed. The measurement parameters of CSD were length, width, depth and thickness of the remaining muscular layer (TRM), depth/TRM. \n \n \nResults \nThere were 7 patients missed diagnosis among 199 patients enrolled preoperative ultrasound examination and 199 patients were all diagnosed with CSD by magnetic resonance imaging. Totally 155 patients underwent both ultrasound and magnetic resonance examination before operation. The length [(7.74±3.14) mm, (8.57±3.70) mm, P=0.007], width [(13.18±5.66) mm, (16.62±4.12) mm, P 0.05). The morphology of CSD was usually triangular and wedge-shape. The position of uterus with CSD was usually retroflexed uterus. After operation, there were still 82 cases had CSD, but diverticulum were smaller than pre-operation (P<0.05) and the thickness of residual muscular layer after operation (5.53±1.96) mm was significantly thicker than that before operation [(2.43±1.10) mm, P<0.01]. \n \n \nConclusion \nPatients with diverticulum not found by vaginal ultrasound should undergo MRI. Pre-operative transvaginal repair, considering pelvic adhesion patients need MRI. The appropriate combination between ultrasound and MRI plays an important role in diagnosis of CSD and evaluation of operation. \n \n \nKey words: \nUltrasonography;\xa0Magnetic resonance imaging;\xa0Cesarean section;\xa0Cesarean scar diverticulum