彩色多普勒超声诊断恶性滋养细胞肿瘤21例临床分析

目的 探讨经腹壁和经阴道彩色多普勒超声联合应用并结合人绒毛膜促性腺激素(β-HCG)水平检测在诊断恶性滋养细胞肿瘤中的临床应用价值.方法 对妇科21例恶性滋养细胞肿瘤患者实行经腹壁和经阴道彩色多普勒超声联合检查,获得其二维声像图特征及彩色多普勒联合频谱多普勒血流信息,对比血β-HCG水平变化,动态观察和随 访治疗前后的病情变化.结果 21例恶性滋养细胞肿瘤患者经多种影像学检查结合其他实验室检查并最后病理确诊.病灶位于子宫内膜3例,宫内和肌壁15例,有宫旁转移3例,远处转移2例.病理确诊为侵蚀性葡萄胎12例,绒毛膜癌8例,胎盘部位1例.结论 临床检测血β-HCG是滋养细胞疾病诊断与治疗随访的重要参考指标,经腹和经阴道彩色多普勒超声联合应用并结合血β-HCG水平检测在诊断恶性滋养细胞肿瘤中有重要临床应用价值.

Clinical analysis on color Doppler ultrasound for diagnosing malignant trophoblastic tumor in 21 cases

Objective To compare the clinical values between joint application of color Doppler transvaginal scanning and transabdominal scanning with serum β human chorionic gonadotropin(β-HCG) for diagnosing malignant trophoblastic tumor.Methods Color Doppler transvaginal scanning and transadominal scanning were simultaneously performed in 21 patients with malignant trophoblastic tumor in the gynecology department.The 2 dimensional ultrasonographic features and blood flow information of color Doppler and spectral Doppler in malignant trophoblastic tumor were achieved and compared with the change of serum β-HCG levels.The changes of disease condition before and after treatment were dynamically observed and followed up.Results 21 cases of malignant trophoblastic tumor were performed many imaging examinations combined with laboratory examinations and finally diagnosed by pathological examination.Among them,3 cases had focus located in endometrium,15 cases in intra-uterus and uterine muscle wall.3 cases had parametrial tissue metastasis and 2 cases had distant metastasis.According to pathological examination,12 cases were invasivemole,8 cases were choriocarcinoma,1 case was placental site trophoblastic tumor.Conclusion The determination of β-HCG is an important reference index for diagnosis and follow up of trophoblastic disease.Joint application of color Doppler transvaginal scanning and transadominal scanning combined with the detection of serum β-HCG level has important clinical value for the diagnosis of malignant trophoblastic tumor.