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. 2020 Dec;48(12):300060520980217.
doi: 10.1177/0300060520980217.

Contrast-enhanced ultrasound in uterine artery embolization treatment of cesarean scar pregnancy

Dongmei Liu  1 , Xiaoning Gu  1 , Fang Liu  1 , Fuwen Shi  1 , Min Yang  1
Affiliations

Contrast-enhanced ultrasound in uterine artery embolization treatment of cesarean scar pregnancy

Dongmei Liu et al. J Int Med Res. 2020 Dec.

Abstract

Objective: The current study aimed to investigate the application of contrast-enhanced ultrasound (CEUS) in diagnosis and treatment of cesarean scar pregnancy (CSP).

Methods: A retrospective study was performed in 35 patients with clinically suspected CSP who requested termination of pregnancy and underwent contrast-enhanced ultrasound (CEUS). The patients were classified into two groups on the basis of whether they received uterine artery embolization (UAE). The CEUS characteristics of the two groups were reviewed.

Results: CEUS features of CSP were early enhancement of the cesarean scar and continuous infusion of contrast agent between the gestational sac and cesarean scar. Myometrial thickness in the cesarean scar was thinner in the UAE group than in the non-UAE group by CEUS and transvaginal ultrasound. Myometrial thickness measured by CEUS was thinner than that measured by transvaginal ultrasound in both groups. The parameters of the time-intensity curve in the UAE group were characterized by a faster arrival time, shorter time to peak, higher peak intensity, and greater enhancement rate compared with the non-UAE group.

Conclusions: CEUS may be a novel supplementary method to diagnose and assess CSP, and to help evaluate whether UAE is required.

Keywords: Uterine artery embolization; cesarean scar pregnancy; contrast-enhanced ultrasound; gestational sac; myometrial thickness; transvaginal ultrasound.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Flowchart of the study participants. CSP, cesarean scar pregnancy; CEUS, contrast-enhanced ultrasound; UAE, uterine artery embolization; HCG, human chorionic gonadotropin.
Figure 2.
Figure 2.
Myometrial thickness as measured by transvaginal ultrasound (a) and contrast-enhanced ultrasound (b) in an endogenous cesarean scar pregnancy. The myometrial thickness measured by TVS (red line in a) is visibly thicker than that measured by contrast-enhanced ultrasound (red line in b).
Figure 3.
Figure 3.
Contrast-enhanced ultrasound features of an endogenous cesarean scar pregnancy and exogenous cesarean scar pregnancy. (a) Early rapid enhancement of the scar (yellow arrows) in an endogenous cesarean scar pregnancy. (b) Continuous contrast agent perfusion between the gestational sac and the scar (yellow arrows) in an endogenous cesarean scar pregnancy. (c) Contrast-enhanced ultrasound demonstrating a ring-enhanced gestational sac in an exogenous cesarean scar pregnancy (yellow arrows).
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