彩色多普勒超声在恶性滋养细胞疾病中的应用价值

Value of color doppler ultrasonography in malignant trophoblastic disease

目的进一步探讨彩色多普勒(CDFI)及脉冲多普勒(PW)在恶性滋养细胞疾病(MTD)的诊断及疗效观察中的应用价值。方法对21例恶性滋养细胞疾病患者、25例良性葡萄胎及40例正常早孕者行CDFI及PW检查,记录病灶区及子宫动脉血流阻力指数(RI),并记录血绒毛膜促性腺激素(β-hCG)值。结果21例MTD患者中子宫肌壁回声增粗或可见低回声结节,血流丰富,阻力指数<0.5,血β-hCG增高;化疗取得疗效后异常血流逐渐减少,RI呈逐渐升高趋势,血β-HCG逐渐恢复正常,两指标呈负相关。结论彩色多普勒超声显示病灶异常血流图像和脉冲多普勒检测RI低值是诊断恶性滋养细胞肿瘤的重要指标,对监测化疗效果、选择治疗方案均有十分重要的价值。CDFI及PW检测对鉴别良恶性质具有应用价值,与血β-hCG联合应用,既能提高符合率,又可作为评价化疗效果及判断预后的有效指标。

Objective In order to study the value of Color Doppler flow imaging （CDFI） and pulsed wave （PW） in the diagnosis and curative effect of malignant trophoblastic disease（MTD）. Methods CDFI and PW were used to detect 21 patients with MTD, 25 benign moles and 40 normal early pregnants. RI in the foci and β human chorionic gonadotrophic（β-hCG） in the blood serum were determined. Results The uterine wall echoes revealed coarse with low echoic nodes, the trophoblast invasive wall was hypervasctdar and the resistive index（Rl） was less than 0.5, and the blood β-hCG increased. After chemotherapy, the hypervascularity de- creased, RI increased higher, and β-hCG returned normal. Both methods were found positively correlate. Conclu- sion CDFI can show blood flow abnormality in the focus and PW can show low RI. These are the important in- dices for diagnosis of the MTD,when combined with β-HCG it might provide higher diagnostic efficacy and could serve as effective follow-up and prognostic prediction after chemical therapy.