彩色多普勒血流显像在恶性滋养细胞肿瘤检测中的应用

目的：探讨彩色多普勒血流显像（CDFI）技术在子宫内恶性滋养细胞肿瘤检测中的应用。方法：对27例恶性滋养细胞肿瘤组、27例早孕组及20例良性滋养细胞肿瘤对照组采用彩色多普勒超声进行检测。对其子宫肌壁内血流信号，动脉频谱，动静脉瘘性频谱等CDFI特征进行对比分析。对27例恶性滋养细胞肿瘤化疗前后CDFI特征进行对比分析。结果：子宫肌壁内血流信号丰富：恶性滋养细胞肿瘤组24／27，良性滋养细胞肿瘤对照组2／20，早孕组3／27；高速低阻力性动脉频谱：恶性滋养细胞肿瘤组25／27，良性滋养细胞肿瘤对照组1／20，早孕组3／27；恶性滋养细胞肿瘤组动静脉瘘性频谱（26／27）。恶性滋养细胞肿瘤患者全身化疗后子宫肌层血流丰富区逐渐缩小，病灶血窦逐步缩小（16／22）。6例从子宫腔注入化疗药物进行补充治疗，均子宫肌层血流丰富区明显缩小，病灶血窦〈3mm，达到正常值。结论：CDFI对恶性滋养细胞肿瘤的诊断及观察其化疗效果均有重要临床价值。

The Clinical Application of Color Doppier Flow Imaging in Malignant Trophoblastic Tumor

Objective:To explore the clinical value of Color Doppier Flow Imaging(CDFI) for diagnosis of malignant trophoblastic tumor in womb and observe the effect of chemotherapy in the disease.Methods:CDFI was performed in 27 cases of malignant trophoblastic tumor,27 of early pregnancy,and 20 of benign trophoblasteic tumor.A comparative analysis of CDFI feature of the flow signal in womb tunica muscularis and the artery frequency spectrum and the frequency spectrum of arteriovenoue fistula beween three groups were also conducted.The chemotherapeutic efficacy in 27 cases malignant trophoblastic tumor was evaluated.Results:The areas of blood flow signal rich in womb tunica muscularis were found in 24 cased of malignant trophoblastic tumor,2 of benign trophobastic tumor and 3 of early pregnancy;the artery frequency spectrum of high speed and low resistance were found in 25 cases of malignant trophoblastic tumor,1 of benign trophoblastic tumor and 3 of early pregnancy;frequency spectrum of arteriovenoue fistula was found in 26 cases of malignant trophotic tumor.Among 22 patients with malignant trophoblastec tumor who received chemotherapy,thre was a reduction of the area of blood flow rich and focus blood sinusoid in womb tunica muscularis of 16 cases after chemotherapy.The other 6 cases treated by chemotherapy in local womb showed a remarked reduction of the area of blood flow rich and blood sinusoid in womb tunica muscularis with focus blood sinusoid <3 mm.Conclusion:It is important to diagnose and observe the effect of chemotherapy in malignant trophoblastic tumor in womb.