title: Early indicators of cervical insufficiency assessed using magnetic resonance imaging of the cervix during pregnancy.
abstract: OBJECTIVE
  To establish the main characteristics of the cervix in pregnant women with cervical insufficiency, by means of magnetic resonance imaging (MRI).
  
  
  METHODS
  A prospective observational case-control study was conducted among 59 pregnant women with cervical insufficiency and 10 normal pregnant women, between their 10th and 28th weeks. The parameters analyzed in the MRI examinations were: precise identification of the cervix; presence of hyposignal at the internal orifice of the cervix; loss of definition of the periendocervical stromal zone (PESZ); presence of hyposignal content inside the amniotic sac (sludge sign) and anatomical and functional biometry of the cervix.
  
  
  RESULTS
  Peripheral hyposignal was found in 41 (85.4%) and loss of definition of the PESZ was observed in 36 pregnant women (73.5%) with cervical insufficiency. Sludge was observed in 46 pregnant women with cervical insufficiency, and this was seen on MRI in 27 cases (58.7%). The mean anatomical and functional lengths of the cervix on MRI in the pregnant women with cervical insufficiency were 3.5 ± 0.8 cm (0.8-4.9 cm) and 28.7 ± 6.3 mm (9-41 mm). None of the normal pregnant women presented hyposignal loss of the PESZ and the sludge sign.
  
  
  CONCLUSIONS
  MRI may be useful for evaluating the cervix and for early identification of signs of cervical insufficiency during pregnancy.
authors.affiliation: Department of Imaging Diagnostics and.
authors.forename: Viviane Vieira Francisco
authors.initials: VV
authors.lastname: Habib
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.forename: Sue Yasaki
authors.initials: SY
authors.lastname: Sun
authors.forename: Dirceu Faggion
authors.initials: DF
authors.lastname: Júnior
authors.forename: Rosiane
authors.initials: R
authors.lastname: Mattar
authors.forename: Jacob
authors.initials: J
authors.lastname: Szejnfeld
authors.forename: Sergio Aron
authors.initials: SA
authors.lastname: Ajzen
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D054791:Cervical Length Measurement / Q000379:methods; D002584:Cervix Uteri / Q000473:pathology*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D002581:Uterine Cervical Incompetence / Q000175:diagnosis*; D055815:Young Adult
keywords: Cervical insufficiency; magnetic resonance imaging; pregnancy