INTRODUCTION : The increasing frequency of cesarean section has led to a rise in postoperative complications. One of these complications is the formation of a «niche» in the uterine scar. To determine the appropriate management strategy for patients at the preconception stage, it is essential to thoroughly assess the condition of the postoperative scar. OBJECTIVE : Evaluate the effectiveness of magnetic resonance imaging (MRI) in assessing the condition of the uterine scar niche following cesarean section. MATERIALS AND METHODS : A retrospective analysis was performed on 63 pelvic MRI scans (1.5/3.0 T) of women aged 18– 45 years with a uterine niche after cesarean section (residual myometrial thickness < 3 mm). Two radiologists independently assessed scar morphometric parameters in T2-weighted imaging. Measurements were performed using RadiAnt DICOM Viewer. Statistical analysis was conducted using StatTech v. 4.8.0 (StatTech LLC, Russia). RESULTS : The analysis of MRI data showed that the residual thickness of the myometrium was 2.5 (2.0; 3.0) mm, with the median depth of the «niche» 5.0 (4.0; 6.2) mm, width 8.0 (6.0; 12.0) mm, and length 9.5 (7.0; 12.0) mm (n=63). The thickness of the adjacent myometrium was 12.0 (10.75; 15.0) mm, and the distance to the external cervical os was 28.0 (24.0; 30.0) mm. The prevalence of minor defects in the scar was 85.7% (54/63), while significant defects were observed in 14.3% (9/63) of patients. An inverse correlation was found between the myometrial thickness and the length of the «niche» (rs=–0.160, p=0.21), and between the residual myometrial thickness and the depth of the «niche» (rs=–0.256, p=0.042). DISCUSSION : The use of magnetic resonance imaging (MRI) in the diagnosis of uterine scars provides high visualization accuracy and minimizes subjective influences from experts. MRI can be a useful tool for predicting the effectiveness of surgical treatment. Correlation analysis demonstrated that deeper and longer scar defects are associated with a reduction in the thickness of the residual myometrium. CONCLUSION: During the preconception period, it is crucial to obtain detailed data on the condition of the scar. To achieve this, an extended protocol for measuring the scar should be used. A thorough description of the scar’s structure will help clinicians make informed decisions regarding the further management of patients.
Translated title of the contributionEvaluation of the state of the uterine scar after cesarean section using magnetic resonance imaging in the diagnosis of «niche»: a retrospective study
Original languageRussian
Pages (from-to)48-55
Number of pages8
JournalЛучевая диагностика и терапия
Volume16
Issue number2
DOIs
StatePublished - 24 Jul 2025

ID: 141921323