MRI appearance of the pelvis in the post cesarean-section patient

Catherine Maldjian, Richard Adam, Joseph A Maldjian, Robert Smith

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Fever in the post-cesarean section patient may indicate the presence of a potentially life-threatening complication, including abscess, ovarian vein thrombosis, and uterine dehiscence. Imaging findings are often utilized to ascertain the presence or absence of such complications. Familiarity with the normal findings in the postoperative period is essential in making this determination. The purpose of this investigation is to describe the MRI appearance of the post-cesarean section pelvis. Over a 67-month period, 50 patients with persistent low-grade fevers following c-section were referred for MR imaging. Imaging was performed 3-10 days postoperatively. Axial T 1- weighted and T 2-weighted images were acquired in addition to sagittal T 2- weighted images. Coronal images were obtained in some cases. Clinical correlation was obtained through the patients charts, confirming discharge of the patients in stable condition. The uterine incision site usually demonstrated findings consistent with subacute hematoma. The anterior uterine myometrium demonstrated enlargement relative to the posterior uterine wall. Bladder flap hematomas were seen in 64% of cases. Three cases (6%) demonstrated parametrial edema and none of these patients demonstrated ovarian vein thrombosis. Two cases of pelvic hematoma were noted. The normal post-c-section incision site may demonstrate increased or decreased signal intensity on T 2-weighted images and intact endometrial and serosal layers mitigate against the diagnosis of incisional dehiscence. Bladder flap hematomas occurred in slightly more than half the cases. Parametrial edema and pelvic hematoma can be seen as post-surgical changes.

Original languageEnglish (US)
Pages (from-to)223-227
Number of pages5
JournalMagnetic Resonance Imaging
Volume17
Issue number2
DOIs
StatePublished - Feb 1 1999

Fingerprint

pelvis
Pelvis
Cesarean Section
Hematoma
Magnetic resonance imaging
Imaging techniques
fever
thrombosis
edema
bladder
veins
Veins
Edema
Urinary Bladder
Thrombosis
Fever
Myometrium
Patient Discharge
charts
Postoperative Period

Keywords

  • C-section
  • Pelvis

ASJC Scopus subject areas

  • Biophysics
  • Clinical Biochemistry
  • Structural Biology
  • Radiology Nuclear Medicine and imaging
  • Condensed Matter Physics

Cite this

MRI appearance of the pelvis in the post cesarean-section patient. / Maldjian, Catherine; Adam, Richard; Maldjian, Joseph A; Smith, Robert.

In: Magnetic Resonance Imaging, Vol. 17, No. 2, 01.02.1999, p. 223-227.

Research output: Contribution to journalArticle

Maldjian, Catherine ; Adam, Richard ; Maldjian, Joseph A ; Smith, Robert. / MRI appearance of the pelvis in the post cesarean-section patient. In: Magnetic Resonance Imaging. 1999 ; Vol. 17, No. 2. pp. 223-227.
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