彩色多普勒超声在滋养细胞肿瘤的鉴别诊断及治疗中的临床应用

Applied value of color Doppler ultrasound in differential diagnosis and treatment of trophoblastic disease

目的：探讨彩色多普勒超声（ＣＤＦＩ）对滋养细胞肿瘤的鉴别诊断价值及化疗效果的评估。方法：应用ＣＤＦＩ对１１例良性葡萄胎及２３例恶性滋养细胞肿瘤的子宫动脉及肿瘤内的血流进行了检测，３０例正常及异常早孕组作为对照组。结果：（１）良性葡萄胎病灶内未见彩色血流显示，恶性滋养细胞肿瘤内见丰富彩色血流信号，频谱呈高速低阻型；（２）恶性滋养细胞肿瘤的子宫动脉及肿瘤内血管的阻力指数（ＲＩ）显著低于葡萄胎及对照组，差异有非常显著意义（Ｐ＜０．０１）；（３）ＣＤＦＩ监测化疗效果与血β－ＨＣＧ相关性好。结论：ＣＤＦＩ在滋养细胞肿瘤良、恶性的判断及化疗效果的监测上是一个很有价值的方法。

Objective:To assess the value of color Doppler ulfrasound in differential diagnosis of trophoblastic disease and monitor the clinical response to chemotherapy.Methods:The uterine artery and intratumor blood flow were measured by color Doppler flow imaging(CDFI)in 11 patients with hydatidiform mole(H mole)and 23 patients with persistent trophoblastic tumor (PTT), with 30 cases of normal and ectopic early pregnancies as control.Results:(1)No evident intratumor blood flow could be seen within H mole,abundant red and blue colored flows could be showed in anechoic areas of PTT,and the spectra showed low impedance flow with high diastolic component;(2)the resistance indices (RI) of uterine artery and intratumor vessels in PTT were significantly lower than those in H mole and controls ( P <0.01);and(3)the findings of CDFI corresponded well with serum β HCG levels.Conclusion:CDFI is a useful method in evaluating the type of trophoblastic tumors and in monitoring the tumor response to chemotherapy.