Diffusion Tensor Imaging of the Cervix Could Predict Miscarriage or Early Labor
A new MRI technique can produce high-resolution images of the human cervix architecture for potential pregnancy monitoring purposes.
The architecture of the uterine cervix has an impact on why some women miscarry or go into early labor. During pregnancy, the cervix becomes a load-bearing organ that resists forces generated by the fetus and amniotic sac. One hypothesis states that a dense collagen network is mostly responsible for its strength, but this hasn't been thoroughly tested.
For the first time, researchers have obtained extremely high-resolution images of the human cervix architecture with an MRI technique called diffusion tensor imaging. Typically used for analyzing the white matter tracts of the brain, an interdisciplinary team at the University of Leeds applied diffusion tensor imaging to the uteri of nonpregnant women who underwent hysterectomy. Their results were published Dec. 11 in the British Journal of Obstetrics and Gynaecology.
Diffusion tensor imaging creates structural images by measuring the Brownian motion of water molecules traveling through fiber tracts. Seven women who needed to undergo hysterectomy enrolled in the study, and their cervical tissue samples were imaged ex vivo using the technique after the surgery.
The high-resolution images revealed two main regions of the cervix: an outer circular layer and an inner longitudinal layer. The circular fibers in the upper third of the cervix, which corresponds to the internal opening of the cervical canal, showed greater tract density and organization when compared to other fibers in the cervix. This opening, called the internal os, typically collapses in cases of early cervical dilation.
This supports the hypothesis that women with weaker than normal tract density may be more susceptible to miscarriage or early labor. Eventually, the technology could be used to monitor women for potential signs of these issues -- even before they become pregnant.