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Abstract Objective: To evaluate the value of transvaginal color coppler ultrasound (TCCU) and magnetic resonance imaging (MRI) for diagnosing women with cesarean scar pregnancy (CSP) early. Methods: 163 women with CSP from July 2015 to February 2018 were analyzed retrospectively. All the included women were diagnosed by TCCU and MRI, and postoperative pathological diagnosis was used as the gold standard. The value of TCCU or MRI for diagnosing CSP was analyzed. Results: Pathological diagnosis confirmed that 138 women in these 163 women were CSP, and the other 25 women were intrauterine pregnancy. The sensitivity, specificity, accuracy, misdiagnosis rate, missed diagnosis rate, positive predictive value and negative predictive value of TCCU for diagnosing CSP were 71.0%, 84.0%, 73.0%, 16.0%, 29.0%, 98.1%, and 34.4%, respectively. The sensitivity, specificity, misdiagnosis rate, accuracy, missed diagnosis rate, positive predictive value and negative predictive value of MRI for diagnosing CSP were 94.9%, 96.0%, 4.0%, 95.1%, 5.1%, 99.2%, and 77.4%, respectively. The sensitivity and accuracy of MRI for diagnosing CSP were significant higher than those of TCCU, and the misdiagnosis rate and missed diagnosis rate were significant lower than those of TCCU (P<0.05). Conclusion: TCCU for diagnosing CSP has some accuracy, which can be used as the first choice of diagnosing CSP. As for the difficult cases, TCCU combined with MRI can be further improving the diagnostic accuracy.
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