Background: In clinical practice it is an ongoing challenge to distinguish between angular pregnancy and interstitial pregnancy. With the three-dimensional (3D) magnetic resonance imaging (MRI) being increasingly used, it is worth exploring its role in differentiating angular pregnancy from interstitial pregnancy. This study aims to investigate how 3D MRI can help reveal the differences between these two special pregnancies in the early diagnosis. Methods: We reviewed and analyzed the 3D MRI images of 50 patients with interstitial pregnancy and 55 patients with angular pregnancy retrospectively. Imaging features were identified to compare these two special pregnancies, and the ROC (Receiver Operating Characteristic) analysis was conducted to assess the diagnostic performance. Results: The significant differences of the 3D MRI imaging features between interstitial pregnancy and angular pregnancy were found in the outline of uterus cavity (p < 0.001), involvement of junctional zone (p < 0.001), the signal of surroundings (p = 0.005), the relationship with round ligament (p = 0.042), and the overlying myometrial thickness (p = 0.041). Furthermore, the multivariate logistic regression analysis identified a series of significant indicators for angular pregnancy, including the junctional zone involvement, being-surrounded by hyper/iso-intensity on 3D images, and the asymmetric outline of uterus cavity. Combining these three imaging features, the AUC (Area under the Curve) of ROC curve was 0.87 in distinguishing interstitial pregnancy from angular pregnancy. Conclusions: This study suggests that 3D MRI can help distinguish angular pregnancy from interstitial pregnancy in clinical practice, with the advantages that conventional MRI or ultrasound does not have. Through the significant image features, 3D MRI plays an important role in improving the timing of diagnosis, avoiding unnecessary interventions, and preventing hemorrhage in clinical practice.

Bronchial artery embolization is an effective and widely used procedure for controlling hemoptysis. Cerebral infarct after bronchial artery embolization is a rare and severe complication. We report two cases of cerebral infarct complicating bronchial artery embolization, most likely due to errant embolic passage through anastomoses with the ipsilateral subclavian artery.

The aim of this study was to compare the reproductive outcomes of patients with cesarean scar pregnancies (CSP) following uterine artery embolization (UAE) and dilation and curettage (D&C) treatments, and to evaluate the impact of UAE on fertility. and methods: A retrospective case-control study was conducted. Patients diagnosed with CSP between 2019 and 2021 were included in the study. Clinical data and fertility outcomes were collected and reviewed retrospectively. Patients were divided into two groups based on their treatment option: the UAE combined with D&C group and the D&C alone group. A total of 91 CSP patients were enrolled in the study. Of these, 49 were treated with D&C, while 42 received UAE combined with D&C. The average gestational age in the UAE group was significantly longer than that in the D&C group. The average diameter of the gestational mass was significantly larger in the UAE group than in the D&C group (42.2 ± 19.8 mm vs 23.8 ± 15.9 mm). The other clinical features were not significantly different between the two groups. The average menstrual recovery time was 1.0 ± 0.20 months (range: 1–2 months) in the D&C group, and 2.0 ± 2.85 months (range: 1–18 months) in the UAE combined with D&C group, with a significant difference between the two groups. The average menstrual blood volume (MBV) decreased in 79 % of patients in the UAE group, compared to 18 % in the D&C group, with a significant difference between the two groups. There was no significant difference between the two groups in terms of pregnancy rate and birth rate (75 % vs 78 %, 63 % vs 56 %). UAE combined with D&C is an efficient and safe treatment for CSP. Our study showed that decreased MBV and longer menstrual recovery time in UAE combined with D&C group, but there are no statistical difference in fertility outcomes between the two groups, which suggests probably a reversible impact on the reproductive function.

This study aims to evaluate pregnancy rates using a novel classification system based on hysterosalpingography (HSG) findings, categorizing tubal patency as either patent or functionally deficient. Furthermore, the study assesses the predictive value of this scoring system for fertility outcomes. A retrospective cohort study was conducted involving 4461 patients who underwent HSG at an academic radiology center between January 2020 and December 2022. HSG findings and subsequent pregnancy outcomes were systematically analyzed. Of the 2461 patients initially followed up, 301 were excluded due to incomplete data, resulting in a final cohort of 2160 patients. Within two years post-HSG, 970 patients (44.9 %) achieved natural pregnancy, 808 (83.2 %) of whom resulted in live births. In vitro fertilization (IVF) pregnancies accounted for 35.8 % (n = 775). Ectopic pregnancies occurred in 1.8 % of patients, with a higher incidence in those with unilateral tubal occlusion. Using the novel scoring system—where Score 0 indicates bilateral patency, Score 1 indicates unilateral functional deficiency, and Score 2 indicates bilateral functional deficiency—the Score 0 group exhibited the highest natural pregnancy rate (51.1 %), which was significantly higher than that of the Score 1 and Score 2 groups. Natural pregnancy rates were 20.8 % for unilateral hydrosalpinx and 36.7 % for unilateral occlusion. Only 5 % of patients with bilateral hydrosalpinx conceived naturally. Age was a significant factor; women under 35 years had a natural pregnancy rate of 46.8 %, compared to 10.2 % in those over 40 years. Tubal patency status is significantly associated with pregnancy outcomes, and functional deficiencies appear to reduce fertility. The proposed HSG-based scoring system serves as a valuable predictive tool for pregnancy potential. Additionally, the presence of hydrosalpinx is associated with adverse pregnancy rates.