Department of Ultrasound Medicine, Tangdu Hospital, Air Force Medical University, No. 1 Xinsi Road, Xi'an 710038, China. Objective: To evaluate the diagnostic value of saline contrast sonohysterography (SHG) in cesarean section (CS) scar evaluation.
Methods: 98 Patients Who had a history of CS and presented with secondary infertility or postmenstrual spotting were examined by both conventional transvaginal ultrasound (TVS) and SHG. Patients were divided into two groups according to whether the diverticulum presented or not by TVS. The detection rate of diverticulum was compared between TVS and SHG, and the size of diverticulum and the thickness of residual muscle layer were compared before and after SHG. Results: 62 cases with diverticulum were detected by SHG, while 43 cases were found through TVS. The detection rate of diverticulum by SHG was significantly higher than that of TVS (P< 0.05). Hysteroscopy was performed in 85 of the 98 patients, and diverticula was found in 74 of them. The diagnostic rate of TVS was 49.4% and 67.1% for SHG with P< 0.05. The size of diverticulum measured by TVS was as follows: sagittal, longitudinal and transverse diameters were 0.47±0.03cm, 0.57±0.05cm and 0.74±0.06cm, respectively. The residual muscle thickness is 0.48±0.21cm. The measurements of sagittal, longitudinal and transverse diameters by SHG were 0.67±0.06cm, 0.59±0.05cm and 0.92±0.08cm, respectively. The residual muscle thickness is 0.53±0.26cm. 8 cases with endometrial and cervical canal polyps were detected by TVS; while 16 cases with endometrial and cervical canal polyps were detected by SHG, and another 7 cases with intrauterine adhesions and 12 cases with incisional cysts were detected.
Conclusion: SHG is superior to TVS in CS scar evaluation in finding hiding diverticulum, evaluating the structure of the diverticulum and other intrauterine lesions.
