The use of contrast-enhanced magnetic resonance imaging to diagnose cesarean scar pregnancies

Objective: To evaluate whether contrast-enhanced magnetic resonance imaging (MRI) could be used as a routine method for diagnosing cesarean scar pregnancy (CSP). Methods: A retrospective study was performed, with review and analysis of medical records, ultrasonography results, MRI results, and clinical outcomes of 44 women with CSP admitted to Beijing Chaoyang Hospital, Beijing, China, between May 2010 and November 2013. The women initially underwent ultrasonography followed approximately 5 days later by contrast-enhanced MM. Results: CSP was accurately diagnosed in 42 cases (95.5%) using contrast-enhanced MRI compared with 39 cases (88.6%) using ultrasonography (P < 0.05). Two cases with a heterogeneous signal intensity pattern using MRI were initially misdiagnosed as a uterine leiomyoma and a trophoblastic tumor. No contrast agent-related complications occurred. The typical findings of a gestational sac embedded in the anterior lower part of the uterus in the sagittal T2-weighted views were identified in all the patients. All patients recovered well without experiencing major morbidity after treatment. Conclusion: Contrast-enhanced MRI could be used as a reliable adjunct and initial imaging modality for diagnosing CSP in select cases. The imaging features of contrast-enhanced MRI may result in a more accurate diagnosis before specific treatment for CSP. (C) 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.