MR appearance of uterine dehiscence in the post-cesarean section patient

Purpose: CT has been shown to be unreliable for detecting uterine dehiscence in the postoperative period after cesarean section (c-section). The purpose of this investigation is to describe the MR appearance of uterine dehiscence in this setting and identify features that distinguish complete from partial dehiscence. Method: Over an 82 month period, all charts and MR reports of patients that underwent MRI of the pelvis after c-section were reviewed for uterine dehiscence. Altogether, 55 patients were imaged. Positive cases for dehiscence were retrospectively reviewed by two radiologists. Imaging criteria for complete dehiscence consisted of transmural disruption. Criteria for partial dehiscence consisted of disruption of the endometrial and/or serosal layer, without transmural extension. Results: On MRI, five patients demonstrated abnormalities suggestive of incisional dehiscence. Based on these imaging criteria, two of these showed complete dehiscence that was proven at surgery and three showed findings of partial dehiscence. The optimal imaging plane was perpendicular to the incision. Conclusion: MR features may be utilized to identify total uterine dehiscence and may be more effective than CT.