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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.

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