Predict intraoperative hemorrhage during curettage treatment of cesarean scar pregnancy using free-breathing GRASP DCE-MRI

Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy with curettage often being the first-line treatment. However, uncontrollable intraoperative hemorrhage is one of common complications during the treatment, making its prediction a critical for treatment planning. The aim of this study was to explore the feasibility of using GRASP DCE-MRI to characterize peritrophoblastic perfusion and predict intraoperative hemorrhage for CSP. The study found that presurgical Wash-in, TTP, iAUC, Ktrans, and Ve were significantly different between hemorrhage and non-hemorrhage groups identified during curettage. The ROC-AUC analysis further demonstrated their capability of serving as intraoperative hemorrhage predictors for CSP.