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The use of magnetic resonance imaging in the assessment of the cervical hydration state

As part of a preliminary investigation in the assessment of the connective tissue changes in the cervix by magnetic resonance imaging (MRI), a 32 year old primigravida was asked to participate in a study of the serial evaluation of the MRI images of the cervix. Informed consent was given by the woman and the study had been approved by the local ethical committee. Magnetic resonance imaging offers a noninvasive method of imaging tissues and assessing their hydration state. At the gestations studied, MRI scanning is not associated with any harmful effects on the fetus using the machines currently in use for diagnostic imaging. MRI has been demonstrated to be of value in pregnancy without any adverse effects (Powell et al. 1988a, b; Binkovitz et al. 1991). For this study a Fonar Beta 3000 MRI scanner with a 0.3 Tesla resistive magnet was used (Fonar Corporation, Melville, New York, USA). There are a number of methods of accentuating various aspects of scan images. Relaxation times T1 and T2 are the constants relating the length of time for the signal to decay after stimulation by the radio-frequency. T1 (or spinlattice relaxation) is the decay in proton spin which occurs due to interference between the static magnetic field of the magnet and their precessing charges. T2 (spin-spin relaxation or transverse relaxation) is the decay occurring due to interference from neighbouring protons, or more correctly, the decay resulting from loss of phase coherence of the spin due to this. T1 weighted scans have the advantage of demonstrating the anatomy of the structures clearly, but are not of value in the assessment of hydration states of the tissues. T2 weighted scans will differentiate hydration states of various tissues, and such techniques have been used to quantify the inflammatory response seen in cases of dermatomyositis (Hernandez et al. 1990; Fijino et al. 1991; Keim et al. 1991). A value for the brightness of the tissue taken with the software available on the scanner is compared with adjacent fat or fluid within the bladder. The resulting ratio gives an indication of the relative hydration of that tissue on T2 weighted scans. For the purpose of this study, T2 weighted scans were taken serially from 34 weeks gestation. Images were constructed in the sagittal plane at 4 mm intervals ensuring