ABSTRACT

Background: The purpose of the study is to compare the ultrasound and MRI diagnostic accuracy for the judgment of lower segment cesarean scar after cesarean for attempting the trial of labor.

Aim: To measure the lower segment scar in pregnant ladies after 37th week by using Trans abdominal ultrasound and MRI

Methodology: This observational case control study was conducted in the Lahore General Hospital Diagnostic Radiology Department from the period Jan 2019 to June 2020.Sample size selected was 40 pregnant ladies with prior cesarean history and want to avail the trial of labor for delivery. The thickness of scar was measured with the help of ultrasound and MRI and was also compared with the results of surgeries. Cut off value was also identified so that the normal scar can be differentiated from abnormal scar and also the comparison was made between the findings of MRI and ultrasound with intra operative results to measure the scar thickness.

Results: The results of the study showed that both imaging modalities have good diagnostic accuracy and no significant difference was observed. From the study the accuracy of ultrasound was observed 96% while the MRI diagnostic accuracy was 90%.The mean age group of the participants were 28.36± 3.28 years. Scar thickness mean calculated from the findings of ultrasound was 3.34 mm ± 1.21 mm and the mean scar measurement from the results of MRI was calculated 3.4 mm± 1.14 mm.

Conclusion: When compared both results in the present study it was found that the ultrasound is more convenient and cost effective option as compared to the MRI and MRI alone don’t provide any additional information about the level of scar thickness. The diagnostic accuracy of MRI from the present study was 90% and diagnostic accuracy of Ultrasonography was 96%.

Keywords: MRI, Ultrasound, Cesarean section