彩色多普勒血流显像对滋养细胞肿瘤诊断的探讨

The Study of the Color Doppler Flow Image in the Diagnosis of the Gestational Trophoblastic Tumors

目的 探讨彩色多普勒显像技术对滋养细胞肿瘤的诊断价值。方法 运用彩色多普勒血流显像技术 ,观察子宫的彩色血流图像。将子宫彩色血流图像分类并且测算宫壁血流阻力指数 ,同时记录血清绒毛膜促性腺激素 (β hCG)值。结果 ①本研究组中 13例GTT患者的子宫图像异常 ,并可分为四种类型 :弥漫型、彩球型、血窦型、实质型。其中前三型是可变化的。 2例GTT患者 (以肺转移入院 )的子宫为正常型图像。对照组中 33例为正常型图像 ,5例为异常中的弥漫型图像 ,后者经对症处理后在短期内全部转为正常型。②研究组的子宫壁血流RI平均值为 0 32 9,对照组的 >0 5 ,两者差异显著 (P <0 0 1)。③在 2例早期侵蚀性葡萄胎的子宫病变中异常血流图像检出时间比 β hCG值的异常表现提前了 4～ 6周。 结论 CDFI显示的异常血流图像和低RI是诊断GTT子宫病变的重要指标。CDFI是早期诊断侵蚀性葡萄胎的重要手段之一。

Objective To study the value of the color Doppler flow image (CDFI) in the diagnosis of the gestational trophoblastic tumors (GTT). Methods We categorized these color flow images (CFI) and the resitance indexies of the uterine muscular layer were calculated.The serum β-human chorionic gonadotropin (β-hCG) leves were measured. Results ①In the sduding group the images of the uterus ( n =13) were abnormal.They were categorized as four types:diffuse type,clourful ball type,lacunar type and compact type according to their features.The two patients with metastasis in the lung,the images of the uterus were normal.The first three types of them are changeful.The control group had two types,including normal type ( n =33) and diffuse type ( n =5).The later all changed into normal type within 6～8 weeks.②The mean blood flow resistence index (RI 0 39±0 11) of the uterine muscular layer in the studing group is less than it in control group(RI>0 5). The difference between the groups was statistically significant ( P <0 01).③The abnormal CFI appeared earlier than β-hCG in the invasive mole. Conclusion Abnormal CFI and lower resistance index (RI<0 5) are the important features for uterine lesions of GTT and as a important method it was useful for the early diagnosis of the invasive mole. [