晚期滋养细胞肿瘤转移灶声像图特征

目的探讨晚期滋养细胞肿瘤转移灶的彩色多普勒声像图特征。方法回顾性分析6例滋养细胞肿瘤患者临床、血清β-hCG检测结果及其转移灶的彩色多普勒与频谱多普勒超声声像图特征。结果6例中1例绒毛膜癌（继发于流产后）彩色多普勒超声见结肠转移灶：5例侵蚀性葡萄胎（葡萄胎清除术后1-3个月发生）彩色多普勒超声检查除子宫肌壁病变外盆侧壁网状转移灶2例、腹腔转移灶1例、右肾转移灶1例，结肠转移灶1例。绒毛膜癌和侵蚀性葡萄胎子宫肌壁病变及转移灶的声像图特征雷同。彩色多普勒显示血流丰富，五彩缤纷状．多普勒流速曲线呈高流速低阻力型，阻力指数范围0．42±0．04。6例中1例绒毛膜癌结肠转移灶手术切除。其余均化疗治愈。结论彩色多普勒超声检查能即时发现晚期滋养细胞肿瘤转移灶。

Metastasis of advanced trophoblastic tumors on ultrasonography

Objective To evaluate characteristics of metastasis of advanced trophoblastic tumors in abdominopelvic cavity by color Doppler ultrasound. Methods An analysis of 6 cases of trophoblastic tumor was performed. Clinical appearances, sonographic findings, and serum β-hCG concentration were followed-up. Color Doppler ultrasound were performed to detect the trophoblastic tumor and metastasis in abdnminopelvic cavity. Results Of the 6 patients, 1 was chorlocarclnoma （occurred after an abortion） with metastasis in colon detected by color Doppler ultrasound. Other 5 cases were invasive hydatidiform mole （occurred after one to three months of dilation and suction evacuation） With metastasis in abdominopelvic cavity detected by color Doppler ultrasound. Ultrasound detected the invasion of uterine muscular layer, and the site metastasis in pelvic wall （n=2）, abdominal cavity（n=1）, right kidney（n=1） and colon（n=1）. The imaging features between metastasis of invasive hydatidiform mole and choriocarcinoma were similar. Color Doppler ultrasound showed abundant flow. Doppler waveforms showed resistive indices of 0.42±0.04 for metastasia lesion, and it is the same lower resistive indices as invasive lesion in uterine mus- cular layer. Except a choriocarcinoma with colonic resection, Color Doppler ultrasound showed no blood flow signal after chemotherapy. Conclusion Metastasis of advanced trophoblastic tumor in abdominopelvic cavity can be detected by color Doppler ultrasound.