Abstract: This study investigated the value of magnetic resonance imaging (MRI) combined with serum alpha-fetoprotein (AFP) in diagnosing cesarean scar pregnancy (CSP) and evaluating placenta accreta. 73 patients with suspected CSP were selected as the CSP group, 63 normal pregnant women were selected as the normal pregnancy group, and 63 healthy non-pregnant patients were selected as the healthy non-pregnant group. MRI examination was performed, serum AFP was detected by radioimmunoassay, and the data were analyzed statistically. The results showed that among 73 patients with suspected CSP, 63 were confirmed to be CSP by surgery and/or pathological examination. The accuracy rate of MRI diagnosis of CSP was 95.24%, of which 48 were type Ⅰ (76.19%), and 10 cases type Ⅱ (15.87%), 2 cases of type Ⅲ (3.17%), the accuracy rate of diagnosing placenta accreta was 88.24%. Comparison of serum AFP levels, CSP group > normal pregnancy group > healthy non-pregnant group (P<0.05). The AUC for the diagnosis of CSP was 0.784, and the AUC of serum AFP combined with MRI for the diagnosis of CSP was 0.850. The serum AFP of patients with placenta accreta was higher than that of non-accreta patients. The AUC of serum AFP to evaluate placenta accreta was 0.748, and the AUC of serum AFP combined with MRI to evaluate placenta accreta was 0.881. Therefore, MRI combined with serum AFP can be an effective solution for the diagnosis of CSP and placenta accreta.

Key words: magnetic resonance imaging, alpha-fetoprotein, cesarean scar pregnancy, placenta accreta