Value of MRI combined with transvaginal ultrasonography in the diagnosis of caesarean scar pregnancy / 实用放射学杂志

ABSTRACT

Objective To explore the value of MRI combined with transvaginal ultrasonography in the diagnosis of cesarean scar pregnancy.Methods Appearances of MRI and transvaginal ultrasonography of cesarean scar pregnancy confirmed by surgery and pa-thology in 30 patients were retrospectively reviewed,and the diagnostic value of MRI and transvaginal ultrasonography in the cesare-an scar pregnancy were compared and analyzed.Results MRI and transvaginal ultrasonography clearly demonstrated the gestational sac at cesarean scar of lower uterine in 30 patients including cystic sacs in 22 and solid ones in 8.Both MRI and transvaginal ultra-sonography showed 5 gestational sacs were located at the myometrium and 1 7 extended to uterine cavity.Intrauterine hemorrhage was detected by MRI in 12 patients and by transvaginal ultrasonography in 8.Transvaginal ultrasonography found 14 yolk sacs and 12 embryonic buds with embryonic heartbeat in 8.However,MRI cannot differentiate yolk sac from embryonic bud,and not judge the embryonic heartbeat.Preoperatively,28 patients were diagnosed as caesarean scar pregnancy and other 2 were as trophoblastic tumor by MRI with an accuracy rate of 93%;meanwhile,27 were diagnosed as caesarean scar pregnancy and other 3 as trophoblastic tumor by transvaginal ultrasonography with an accuracy rate of 90% .There was no statistical difference in diagnostic efficiency be-tween MRI and transvaginal ultrasonography (P >0.05).Conclusion The diagnoses of cesarean scar pregnancy by both MRI and transvaginal ultrasonography is highly consistent with pathological results.The combination of two imaging modalities may maxi-mize their advantages and provide more detailed information for rapid diagnosis of cesarean scar pregnancy.