COMPARING ULTRASOUND AND MRI OF SCARRED M YOMETRIUM

To determine whether ultrasound (US) or magnetic resonance imaging (MR I) gave more accurate and objective information about the thickness an d continuity of scarred isthmical myometrium following previous Caesar ean section (CS), US and MRI assessments of the scarred myometrium in 10 pregnant women (37-41 weeks gestation) after 1-8 CS were compared w ith each other and with findings at subsequent elective CS. Vaginal ul trasound gave more accurate information about the condition of the sca rred isthmical myometrium than MRI, since US always allowed precise di fferentiation of isthmical myometrium from the urinary bladder wall an d thus measurements of the scar thickness; there was a good correlatio n to intraoperative observations. MRI achieved better contrast resolut ion with T2- than T1-weighted and proton density-weighted spin-echo se quences. However, differentiation of the various tissues was either im possible (T1- and protondensity-weighted sequences) or less informativ e than with US. Image quality of body and posterior wall of the uterus was better with MRI (T2-weighted sequence) than with US.