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| Clinical value of ultrasound and magnetic resonance imaging in diagnosis of cesarean scar pregnancy |
| Department of Ultrasound, Huaihe Hospital, Henan University; Department of Radiology, Huaihe Hospital, Henan University, Henan |
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Abstract Objective: To investigate the value of ultrasound(US) and magnetic resonance imaging( MRI) in diagnosis of cesarean scar pregnancy(CSP), and to explore the feasibility of US combined with MRI to improve the value for diagnosing cesarean scar pregnancy. Methods：Data of 68 patients who were initially diagnosed as CSP were collected. The sensitivity, specificity and accuracy of US, MRI, US combined with MRI were compared. The diagnostic gold standard was pathology. Results：56 patients were confirmed as CSP and 12 patients were confirmed as intrauterine pregnancy by postoperative pathology in the all 68 patients, while 48 patients were diagnosed CSP by US, and 50 patients were diagnosed CSP by MRI, and 55 patients were diagnosed CSP by US combined with MRI. The sensitivity of the three method was 85.71％, 83.88％, 85.29％, respectively. The specificity of the three method was 89.29％, 7500％, 86.76％, respectively. And the accuracy of the three method was 96.43％, 83.33％, 94.12％, respectively. There was no statistical significant difference in the accuracy among three methods(P=0.049), US compared to MRI(P=0.085,＞0.05) and MRI compared to US combined with MRI(P=0.028,＞0.017) had no statistical significant difference, but US compared to US combined with MRI hadstatistical significant difference (P=0.016＜0.017). In 56 CSP patients, gestational sac was found in 40 patients and solid mass was found in 16 patients by pathology. Among them, 39 gestational sac and 9 solid mass were diagnosed by US, 34 gestational sac and 16 solid mass were diagnosed by MRI, and 39 gestational sac and 16 solid mass were diagnosed by US combined with MRI. There was statistical significant difference in diagnosing gestational sac and solid mass between US and MRI (P=0.035, P=0.003). Conclusion：The coincidence rate in diagnosis of CSP by US or MRI is higher. US is superior to MRI for diagnosing gestational sac, while MRI is better than US for diagnosing solid mass. US combined with MRI has more value in early diagnosis of CSP and can reduce misdiagnosis rate.
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