Objective To examine the use of contrast-enhanced ultrasound(CEUS)for diagnosing and treating cesarean section scar pregnancy(CSP)providing a reference for clinical diagnosis and treatment of CSP.Methods The study retrospectively collected data from 80 suspected patients with CSP who were admitted to the Second Hospital of Jiaxing be-tween January 2017 and January 2021.All patients underwent transvaginal ultrasonography and CEUS examination prior to surgery.The study compared the diagnostic efficacy of vaginal ultrasound and CEUS for CSP to surgical pathology,and observed the ultrasonographic manifestations;The parameters of contrast-enhanced ultrasound time-intensity curve(TIC)were compared between CSP and non-CSP patients,and the differences of CEUS related indexes in patients with different surgical methods were analyzed.Results Out of 80 patients suspected of having CSP,60 cases(75.00％)were con-firmed through operation and pathology.CEUS demonstrated significantly higher diagnostic sensitivity(96.67％vs.86.67％)and accuracy(93.75％vs.83.75％)compared to transvaginal ultrasound,which was considered the gold standard(P＜0.05).Out of 60 patients with CSP,18 cases exhibited extravasation,36 cases showed rich blood grading,and 46 cases showed gestational cystic lesions;The CEUS images revealed a"bagel"sign in 55 cases.The onset and peak times of angiography in patients with cerebral small vessel disease(CSVD)were earlier than those in patients with-out CSVD(P＜0.05),Additionally,the peak intensity and rate of enhancement were greater in patients with CSVD(P＜0.05).The proportion of the major blood supply to the gestational sac/mass in the scar and the chorionic membrane/ear-ly placenta completely covering the scar was found to be higher in laparoscopic surgery than in ultrasound/hysteroscopy(P＜0.05),Additionally,the scar thickness was smaller in laparoscopic surgery(P＜0.05).Conclusion CEUS is typ-ically characterized by the"bagel"sign in the diagnosis of CSP,which has greater diagnostic efficacy than transvaginal ultrasound,Additionally,the characteristics of the main blood supply site of CEUS pregnancy sac/mass may affect the treatment of CSP.
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