阴道彩超对恶性滋养细胞肿瘤的诊断和化疗疗效评价

Evaluation in diagnosis of malignant trophoblastic tumor and of chemotherapy curative effect using transvaginal color Doppler flow imaging

目的探讨经阴道彩色多普勒血流显像(CDFI)及脉冲多普勒(PD)检测对恶性滋养细胞肿瘤早期诊断的价值及在化疗疗效监测中的应用。方法应用CDFI、PD对28例恶性滋养细胞肿瘤病变区进行检测,并与20例不全流产、20例良性葡萄胎作为对照。同时于化疗过程中每一个疗程前后复查CDFI,测定血人绒毛膜促性腺激素(β-HCG)以及测算阻力指数(RI)。结果病变区子宫肌壁有灶性分布的丰富血流,呈现低阻力血流(RI<0.4),化疗后与化疗前相比,CDFI表现具有明显改变;化疗后RI值升高,血βHCG值下降。结论经阴道彩色多普勒超声对恶性滋养细胞肿瘤早期诊断及重复观察化疗效果、判断疾病转归均有十分重要的价值。

Objective To evaluate the early diagnostic value and to monitor the curative effect of chemotherapy in malignant trophohlastic tumor （MTT） based on transvaginal-color Doppler flow imaging （TVS-CDFI） and pulsed Doppler （PD）.Methods Twenty-eight cases of malignant trophoblastic tumor were studied by using CDFI and PD, and the results were compared with those in 20 cases of incomplete abortion and 20 cases of benign hydatidiformmole. β-hurnan chorionic gonadotropin （β-HCG） and resistive index （RI） were also measured before and after chemotherapy using CDFI and PD. Results Plentiful blood flow with low RI （RI〈0. 4） was monitored in myometrium with MTT. Comparison before and after chemotherapy revealed there were significant changes in the results of CDFL After chemotherapy, the RI was higher than that before chemotherapy, while the β-HCG was lower. Conclusion TVS-CDFI is of high value in diagnosing MTT early and monitoring the curative effect of chemotherapy repeatedly and estimating the development of the diseases.