Comparative study of transvaginal ultrasound and magnetic resonance imaging in the diagnosis and classification of cesarean scar pregnancy.

OBJECTIVE

Cesarean scar pregnancy is a rare form of ectopic pregnancy in which the fertilized egg implants within the scar of a previous cesarean section. With the rising global cesarean delivery rate, the incidence of cesarean scar pregnancy has increased, posing serious risks such as massive hemorrhage and uterine rupture. To evaluate and compare the diagnostic and classification accuracy of transvaginal sonography and magnetic resonance imaging in the detection of cesarean scar pregnancy.

METHODS

This retrospective study included 102 patients clinically suspected of cesarean scar pregnancy between January 2023 and May 2024. All patients underwent both transvaginal sonography and magnetic resonance imaging. Using final clinical and pathological diagnoses as the reference standard, the sensitivity, overall diagnostic accuracy, and classification accuracy of transvaginal sonography and magnetic resonance imaging were compared.

RESULTS

Magnetic resonance imaging demonstrated significantly higher sensitivity, diagnostic accuracy, and classification accuracy than transvaginal sonography (p<0.05). Compared with transvaginal sonography, magnetic resonance imaging also showed superior detection rates for intrauterine hemorrhage, villous invasion of the myometrium, and invasion of the bladder and/or cervix, with statistically significant differences (p<0.05).

CONCLUSION

Magnetic resonance imaging demonstrates superior diagnostic and classification accuracy compared to transvaginal sonography in evaluating cesarean scar pregnancy. As a valuable adjunct to ultrasound, magnetic resonance imaging facilitates more accurate diagnosis and individualized treatment planning, thereby reducing the risks of severe complications such as massive hemorrhage, hysterectomy, and maternal mortality in women of reproductive age.