Abstract
Background: In the absence of uterine artery embolization, postpartum myometrial ischemia is an uncommon complication after cesarean section and is easily misdiagnosed. Accurate and prompt differential diagnosis is necessary for clinicians to plan treatment appropriately. Contrast-enhanced ultrasound can effectively visualize the characteristics of microvessels and has proven to be effective for assessing organ perfusion; concurrently, it is convenient, fast, and safe. However, there are few case reports of successful diagnosis of myometrial ischemia after cesarean section using contrast-enhanced ultrasound.
Case presentation: This is the first study to report the successful application of contrast-enhanced ultrasound for diagnosing and evaluating postpartum myometrial ischemia followingcesarean section in patients who have not undergone uterine artery embolization treatment. This approach effectively prevents incorrect or overtreatment stemming from misdiagnosis. Contrast-enhanced ultrasound images of myometrial ischemia have certain characteristics, including “dendritic-like” perfusion and “drop-shape” ischemic area, which can provide reliable evidence for differential diagnosis. In addition, the different degrees and ranges of myometrium ischemia revealed by contrast-enhanced ultrasound may also provide useful information for evaluating the degree of ischemia and prognosis.
Conclusions: Contrast-enhanced ultrasound can provide reliable imaging evidence for diagnosing and assessing postpartum myometrial ischemia.