Abstract：【Objective】To explore the value of MRI in the diagnosis and clinical treatment of cesarean scar pregnancy. 【Methods】A retrospective analysis was conducted by analyzing data collected from 82 patients with cesarean scary pregnancy (CSP) at The First Affiliated Hospital of USTC, Division of Life Science and Technology of China from January 2018 to October 2019. The TVS performance, MRI results, and clinical data of the patients were analyzed. 【Results】Among 82 patients, the final Pathological and Surgical diagnosis included CSP (n=65) and early uterine pregnancy (n=17). Among the 65 cases of CSP, 56 cases were detected correctly and 9 cases were incorrectly diagnosed by ultrasonography. Among the 17 cases of early uterine pregnancy, 9 cases were correctly diagnosed and 8 cases were misdiagnosed. The sensitivity, specificity and accuracy of ultrasonography for diagnosing CSP were 86.15%(56/65), 52.94%(9/17), and 79.27%(65/82), respectively. Among the 65 cases of CSP, 64 Cases were detected correctly and 1 case was detected incorrectly diagnosed by MRI. Among the 17 cases of early uterine pregnancy, 16 cases were diagnosed correctly and 1 case was misdiagnosed. The sensitivity, specificity and accuracy of MRI for diagnosing CSP were 98.46%(64/65),94.12%(16/17), and 97.56%(80/82),respectively. The ROC curve analysis results showed that the AUC of ultrasound was 0.695 (0.584~0.792), which was significantly lower than the 0.963(0.896~0.992) of MRI, and the difference was statistically significant (Z=4.123, P<0.001).According to the results of MRI, hysteroscopic combined Laparoscopic surgery was performed if scar thickness of the uterus ≤ 3 mm. If >3 mm, hysteroscopic pregnancy removal was performed. All 82 patients had successful surgeries and the treatments were satisfactory. 【Conclusion】The sensitivity, specificity and accuracy of MRI for CSP diagnosis are higher than those of transvaginal ultrasonography. Scar thickness of the uterus, measured through MRI, can be used as the standard for the choice of hysteroscopic surgery or hysteroscopic combined with laparoscopic surgery. The choice, made according to MRI results, can achieve better treatment results.
李彩荣, 张爱君, 胡卫平, 吴大保. MRI在瘢痕妊娠的诊治中的应用价值[J]. 医学临床研究, 2021, 38(1): 55-57.
LI Cai-rong, ZHANG Ai-jun, HU Wei-ping, et al. Value of Magnetic Resonance Imaging (MRI) in the Diagnosis and Clinical Treatment of Cesarean Scar Pregnancy. JOURNAL OF CLINICAL RESEARCH, 2021, 38(1): 55-57.
2021, Vol. 38 
