经阴道彩色多普勒超声诊断胎盘部位恶性妊娠滋养细胞疾病的应用分析

目的探讨经阴道彩色多普勒超声诊断胎盘部位恶性妊娠滋养细胞疾病(GTD)的临床价值。方法选择我院2015年6月至2018年3月收治的35例胎盘部位恶性GTD患者为恶性GTD组,选取同期35例胎盘部位良性病变患者为良性GTD组,对比分析两组患者的临床特征和经阴道彩色多普勒超声图像特点。结果①恶性GTD患者的子宫体积均明显增大,平均子宫病灶最大径线为(7.87±0.19)cm。超声显示子宫肌层呈不均质性粗乱光点回声、不规则形强回声,后期可见不规则形液性回声区,病变组织与子宫肌层边界不清。患者子宫动脉均明显增粗、血流信号丰富,部分患者病变部位可见动静脉瘘。②恶性GTD组的PSV、EDV高于良性GTD组,RI低于良性GTD组(P均<0.05);两组患者的血清β-HCG比较无统计学差异(P>0.05)。结论经阴道彩色多普勒超声结合临床特征有助于早期诊断胎盘部位恶性GTD,值得临床推广。

Analysis on Application of Transvaginal Color Doppler Ultrasound in the Diagnosis of Malignant Gestational Trophoblastic Disease at Placenta Site

Objective To explore the clinical value of transvaginal color Doppler ultrasound in the diagnosis of malignant gestational trophoblastic disease(GTD)at placenta site.Methods 35 patients with malignant GTD at placenta site admitted to our hospital from June 2015 to March 2018 were selected as malignant GTD group.At the same time,35 patients with benign lesions at placenta site were selected as benign GTD group.The clinical features and the characteristics of transvaginal color Doppler ultrasound images were compared and analyzed between the two groups.Results①The uterine volume of malignant GTD patients increased significantly,with the average diameter of uterine lesions was(7.87±0.19)cm.Ultrasound showed that the myometrium had heterogeneous,rough and irregular strong echoes,the irregular fluid-like echo zone was visible at the later stage,and the boundary between the diseased tissue and the myometrium was unclear.The uterine arteries were significantly thickened and the signal of blood flow was abundant.In some patients,arteriovenous fistulas were seen at the lesion sites.②The PSV and EDV of the malignant GTD group were higher than those of the benign GTD group,and the RI was lower than that of the benign GTD group(all P<0.05).No statistical difference was found in the serumβ-HCG between the groups(P>0.05).Conclusions Transvaginal color Doppler ultrasound combined with clinical features is helpful for the early diagnosis of malignant GTD in the placenta,which is worthy of clinical promotion.