MR imaging findings in cesarean scar pregnancy / 中华放射学杂志

ABSTRACT

Objective To analyze MRI findings of cesarean scar pregnancy (CSP). Methods The MR findings in 18 patients who were diagnosed as CSP by surgery from March 2010 to November 2011 were retrospectively analyzed,and comparison was made between the MRI findings and surgical results.Results All Gestational sacs (18) were clearly detected by MRI.Among the 18 cases,gestational sac presented as cystic mass with smooth margin located within the scar of uterine wall at the lower anterior uterus in 16 cases.In 2 of the 16 cases,gestational sac was found within the myometrium,whereas in the remaining 14 cases,gestational sac was found partially within the myometrium with extension into the uterine cavity.The anteior wall of isthmus uteri became thinner.In the remaining 2 of the 18 cases,gestational sac presented as irregular,multilobolated mass,growing deep inot the myometrium as well as into the uterinecavity. On T2WI,the mass showed heterogeneous signal intensity. A small amount of hemorrhage within the mass and uterine cavity could be seen on T1 WI. An enhancing solid component with a heterogeneous mass could be seen. All gestational sacs in 18 cases were located at or adjacent to the previous cesarean scar.In the area of cesarean scar,the signal of the uterine wall was disconnected,with focal indentation or thinning and the previous cesarean scar exhibited hypointensity on both T1WI and T2WI.Conclusion CSP has its unique findings on MRI,these specific features can provide useful information in the management of CSP.