恶性滋养细胞肿瘤的彩色多普勒能量图及其定量分析

目的：探讨彩色多普勒能量图（ＣＤＥ）及其定量分析技术在诊断恶性滋养细胞肿瘤中的应用价值。方法：检测１９例恶生滋养细胞肿瘤患者、２５例早孕妇女和２５例正常人子宫血流的彩色多普勒血流显像（ＣＤＩ）和ＣＤＥ表现，进而采用子宫肌层显示的血流面积百分比方法对ＣＤＥ作定量分析。结果：病例组和早孕组子宫动脉血流搏动指数（ＰＩ）较正常组显著降低（Ｐ＜０．００１和Ｐ＜０．０１），但两组间无显著差异。病例组ＣＤＩ显示子宫肌层血流呈灶状分布，早孕组呈散在小灶状分布，正常组无明显血流显示：ＣＤＥ则显示出比ＣＤＩ更为丰富的血流图像，其定量分析揭示子宫平均血流面积百分比在病例组、早孕组和正常组分别为３９．９％、２６．４％和１４．８％，三组间差异显著。结论：子宫动脉血流ＰＩ值诊断与鉴别恶生滋养细胞肿瘤价值有限；ＣＤＥ对子宫血流显示明显比ＣＤＩ丰富，用定量分析方法可以建立一个客观的诊断指标，而且有助于判断疗效

Color Doppler Energy and Its Quantitative Analysis in Malignant Trophoblastic Tumour

The purpose of this study is to investigate the diagnostic value of color Doppler energy(CDE)and its quantitative analysis in malignant gestational trophoblastic tumour.Color Doppler imaging and CDE were used to assess the uterine blood supply and hemodynamics in 19 malignant trophoblastic tumour(group),25 pregnant women in their first trimester(group2)and 25 normal women(group3).The percentage of tthe bood flow area in the section of uterine mvometrium(blood flow area rate,BFAR)was used for CDE quantitative analysis.The results were as follows:1.The pulsatile indices(PI)of uterine arteries both in group I and group 2 were lower than that in group3(p<0 001,P<0 01),but there was no significant difference between group 1 and group 2.2.A Local abundant blood area within the myometrium was detected by CDI in group 1,a scattered blood area in group 2,and non blood area in group 3.The blood areas detected by CDE were much richer and clearer than that by CDI.3.The BFARs of uterine were 39 9%,26 4% and 14 8% in group 1,group 2 and group 3,respectively.There was significant difference between every two groups.Conclud:1.The PI of uterine artery has limited value in diagnosis of malignant trophoblastic tumour;2.CDE can detect much more blood flow in uterine than that CDI can;3.CDE quantitative analysis is recommened,used as an objuctive diagnostic index in malignant trophoblastic tumour.