Application of contrast-enhanced ultrasound for scar pregnancy cases misdiagnosed as other diseases

To demonstrate the feasibility of utilizing contrast-enhanced ultrasound (CEUS) in scar pregnancies misdiagnosed by transvaginal ultrasound (TVS). CEUS was performed in three patients with clinically suspected abnormal pregnancy, and the diagnosis were inconclusive by TVS. Clinical manifestations and features of TVS and CEUS in these cases were analyzed. Three cases included an intramural pregnancy (IMP) after hysteromyomectomy, and two mass-based cesarean scar pregnancy (CSP), the mass was caused by curettage and spontaneous abortion, respectively. In all these cases, early enhancement with high intensity was observed by CEUS at the site of implantation. Moreover, prominently enhanced signal was detected inside the mass, with or without peritrophoblastic ring. No enhancement was detected in clots or masses after effective treatment. CEUS can be used as a supplementary method to diagnose scar pregnancy and evaluate the treatment efficacy, especially in cases with ambiguous results by TVS. •CEUS was performed in three patients with inconclusive diagnosis by conventional ultrasound.•CEUS showed early enhancement with high intensity at implantation site following injection of contrast agent.•CEUS can be used to diagnose scar pregnancy and evaluate treatment efficacy