子宫角部位妊娠与恶性滋养细胞肿瘤的超声声像图及血清绒毛膜促性腺激素对比研究

Comparative Study between Ultrasonograms of Cornual Pregnancy and Malignant Trophoblastic Tumors and Their Serum Human Chorionic gonadotrophin Levels

目的对子宫角部位妊娠和恶性滋养细胞肿瘤的超声声像图特点及血清绒毛膜促性腺激素(β-hCG)水平进行对比研究,以提高二者在子宫角部位妊娠和恶性滋养细胞肿瘤鉴别诊断中的应用价值。方法对经手术病理证实或者临床诊断的35例子宫角部位妊娠和34例恶性滋养细胞肿瘤患者的超声声像图表现及血清β-hCG水平进行回顾性分析。结果子宫角部位妊娠和恶性滋养细胞肿瘤的彩色多普勒血流分布间差异有统计学意义(P<0.05);子宫角部位妊娠较恶性滋养细胞肿瘤更常见条状血流信号(62.9%与29.4%),恶性滋养细胞肿瘤较子宫角部位妊娠更常见筛网状血流信号(44.1%与17.1%)。彩色多普勒血流动力学参数:子宫角部位妊娠患者的收缩期峰值流速(PSV)、舒张末期流速(EDV)显著低于恶性滋养细胞肿瘤患者,而阻力指数(RI)显著高于恶性滋养细胞肿瘤患者,差异均有统计学意义(P<0.01)。子宫角部位妊娠患者血清β-hCG水平显著低于恶性滋养细胞肿瘤患者,差异有统计学意义(P<0.01)。结论超声检查,尤其是彩色多普勒血流显像及彩色多普勒能量图对子宫角部位妊娠和恶性滋养细胞肿瘤的鉴别有一定临床意义;超声诊断结合血清β-hCG水平检测,可以为临床提供更多的信息。

Objective To study comparatively the ultrasonographic characteristics of cornual pregnancy and malignant trophoblastic tumors and the level of serum human chorionic gonadotrophin（β-hCG）,to increase their application values in differential diagnosis of cornual pregnancy and malignant trophoblastic tumors.Methods Ultrasonograms and serumβ-hCG levels were analyzed retrospectively in 35 cases of cornual pregnancy and 34 patients with malignant trophoblastic tumors confirmed by surgery and pathology or clinical diagnosis.Results There was significant difference in color Doppler blood flow distribution between cornual pregnancy and malignant trophoblastic tumors（P0.05）.Strip-like blood flow signals were commoner in cornual pregnancy than in malignant trophoblastic tumor（62.9%,29.4%,respectively）,and mesh-like flow signals commoner in malignant trophoblastic tumor than in cornual pregnancy（44.1%,17.1%,respectively）.In color Doppler hemodynamic parameters,the peak systolic velocity（PSV） and end-diastolic velocity（EDV） were significantly lower but resistance index（RI） higher in cornual pregnancy patients than in malignant trophoblastic tumor patients（P0.01）.Serum β-hCG level of cornual pregnancy patients was remarkably lower than that of malignant trophoblastic tumor patients（P0.01）.Conclusion Ultrasonogram,especially color Doppler blood flow imaging and color Doppler power imaging are of some clinical significance in identification of cornual pregnancy and malignant trophoblastic tumor.Ultrsonogram combined with β-hCG determination can provide more information for clinical treatment.