Evaluation of Association Between Adenomyosis and Cesarean Scar Defect

PURPOSE

This study aims to investigate and compare quantitative factors of the cesarean scar defect (CSD) in symptomatic patients with and without uterine adenomyosis.

METHOD

This study was conducted as a case-control study. Patients who met the inclusion criteria were divided into two groups: with adenomyosis (case) and without adenomyosis (control). The demographic data, medical history, and sonohysterography findings were extracted from the patient's documents and archived images.

RESULT

During 2 years, 310 symptomatic women with a history of previous cesarean section underwent sonohysterography. Among them, 204 patients met the inclusion criteria. The most common chief complaints were post-menstrual bleeding (34.3%) and prolonged bleeding (27%). Cesarean scar depth and width significantly differed between these two groups, and patients with underlying adenomyosis had significantly larger defects (P-value of .009 and .005, respectively). Mean RMT/AMT ratio was 31.83% in the case group and 42.88% in the control group. In our study, RMT/AMT ratios were significantly lower in the case group (P-value of .001). In addition, we performed analysis on a subgroup of patients with one prior cesarean section. Similar results were achieved with a lower RMT/AMT ratio in case group (mean of 31.20% in case group and 46.47% in control group; P-value of .000).

CONCLUSION

Our study showed a strong association between the presence of adenomyosis and larger clinically more significant CSDs. To establish a causative relationship, we suggest a prospective cohort study to follow up the patients and compare the evolution of CSD in patients with and without adenomyosis.

A numerical analysis of a semi-dry coupling configuration in photoacoustic computed tomography for infant brain imaging

In the application of photoacoustic human infant brain imaging, debubbled ultrasound gel or water is commonly used as a couplant for ultrasonic transducers due to their acoustic properties. The main challenge in using such a couplant is its discomfort for the patient. In this study, we explore the feasibility of a semi-dry coupling configuration to be used in photoacoustic computed tomography (PACT) systems. The coupling system includes an inflatable container consisting of a thin layer of Aqualene with ultrasound gel or water inside of it. Finite element method (FEM) is used for static and dynamic structural analysis of the proposed configuration to be used in PACT for infant brain imaging. The outcome of the analysis is an optimum thickness of Aqualene in order to meet the weight tolerance requirement with the least attenuation and best impedance match to recommend for an experimental setting.