Objective: To explore the magnatic resonance imaging (MRI) features of cesarean scar pregnancy (CSP) and analyze the diagnostic value of MRI for early CSP.
Methods: The 3.0 T MRI and ultrasonic findings of 81 patients with CSP were analyzed. The sensitivity, specificity and accuracy of two methods was calculated respectively for the diagnosis of CSP. The diagnostic value of each method was evaluated with receiver-operating-characteristics (ROC) analysis.
Results: Among them, the final pathological diagnoses were CSP (n = 68) and early uterine pregnancy (n = 13). Among 68 cases of CSP, 52 cases were detected and 16 cases incorrectly diagnosed by ultrasound. Among 13 cases of early uterine pregnancy, 11 cases were correctly diagnosed and 2 cases misdiagnosed. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ultrasound for diagnosing CSP were 76.5% (52/68), 11/13, 77.8% (63/81), 96.3% (52/54) and 40.7% (11/27) respectively. Among 68 cases of CSP, 64 cases were detected and 4 cases incorrectly diagnosed by MRI. Among 13 cases of uterine pregnancy, 10 cases were diagnosed correctly and 3 cases misdiagnosed. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MRI for diagnosis of CSP were 94.1% (64/68), 10/13, 91.4% (74/81), 95.5% (64/67) and 10/14 respectively. The ROC analysis yield the area under curve (AUC) of MRI and ultrasonography were 0.941(P = 0.000) and 0.867(P = 0.000) respectively.
Conclusion: The sensitivity and accuracy of MRI are better than those of ultrasound in the diagnosis of CSP. And MRI is quite important for choosing appropiate therapeutic protocols.