恶性滋养细胞肿瘤的彩色多普勒血流显像特征

Characteristics of the gestational trophoblastic tumors with color doppler flow imaging

目的应用彩色多普勒血流显像（CDFI）分析恶性滋养细胞肿瘤的血供类型特征，探讨CDFI在恶性滋养细胞肿瘤早期诊断及化疗监测中的应用价值。方法分析研究组58例恶性滋养细胞肿瘤的血管形态学CDFI改变，对其峰值血流速度及阻力指数进行了测定，定量测量血B—HCG水平监测化疗反应，对照组36例为葡萄胎清宫术后恢复正常患者。结果恶性滋养细胞肿瘤血流图分为3型：弥漫型、血窦型及实质型。研究组58例获病理诊断18例，包括5例弥漫型及8例血窦型结果为恶性葡萄胎，5例实质型为绒毛膜癌。结论不同类型血流图与血β—HCG、子宫血流动力学改变及化疗的反应相关性好。在基层医院应用CDFI不仅可对恶性滋养细胞肿瘤进行早期诊断，而且可用于观察化疗效果，判断疾病预后转归。

Objective The gestational trophoblastic tumors of blood flow supply were analysed with color doppler flow imaging （CDFI） ,to investigate the value of CDFI in early diagnosis and monitoring the response of chemotherapy of the gestational trophoblastic tumors. Methods CDFI was used in diagnosis of 58 patients with gestational trophoblastic tumors. The vascular morphologic manifestations were recorded, and the peak systolic velocity and resistance index of uterine artery were calculated. Serum β-human chorionic gonadotrop in （HCG） levels were measured periodically to monitor chemotherapy response. 36 uneventful post moles uterine were enrolled as controls. Results Histopathologic diagnosis was available for 18 lesions, They were invasive mole in 8 lacunars type and 5 diffuse type lesions,5 choriocarcinoma necrosis in compact type lesions, The gestational trophoblastic tumors were categorized as diffuse type, lacunars type, and compact type according to their vascular patterns. Conclusion Vascular morphologic patterns of gestational trophoblastic tumors correlated well with β-HCG levels,uterine hemodynamics and chemotherapy. CDFI are useful for early diagnosis of the gestational trophoblastil tumors,for evaluating chemotherapeutic results and disease prognosis.