Objective To investigate the diagnostic effectiveness of 2D color Doppler ultrasound and contrast-enhanced ultrasound in caesarean scar pregnancy(CSP)and evaluate its application value in preoperative evaluation.Methods Transvaginal two-dimensional ultrasound examination was performed in 64 patients with clinical suspected as CSP who decided to terminate the pregnancy and contrast-enhanced ultrasound(CEUS)was performed in 30 patients among them.The parameters including the nourishing blood vessel of the gestational sac,arrival time and peak intensity were analyzed.Taken ultrasound-guided curettage and pathological results as golden standard,the diagnostic accuracy of CEUS and two-dimensional ultrasound were calculated.Meanwhile,whether preoperative uterine artery embolization was necessary was determined.Results In this study,64 patients were enrolled while a total of 46 patients were diagnosed with CSP.The sensitivity,specificity,positive predictive value,negative predictive value,diagnostic accuracy and the area under the ROC curves of transvaginal two-dimensional color Doppler ultrasound and CEUS were 93.48％,61.11％,86.00％,78.57％,84.38％,0.773 vs 95.45％,87.50％,95.45％,87.50％,93.33％,0.915,respectively.The diagnosis of CSP by CEUS and two-dimensional color Doppler ultrasound was consistent in 23 cases(76.67％)and inconsistent in 7 cases(23.33％),meanwhile,14 cases(60.87％)were consistent and 9 cases(39.13％)were inconsistent with the classification of CSP,which provided a basis for the preoperative uterine artery embolization.Conclusions CEUS and two-dimensional ultrasound complement each other to make up for the lack of two-dimensional ultrasound alone.Two-dimensional ultrasound combined with CEUS can improve the accuracy of diagnosis of CSP and reduce the possibility of intraoperative bleeding,which has certain guiding significance and application value for the selection of individualized treatment plan.
维普
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