妊娠滋养细胞疾病的超声诊断价值  

DIAGNOSTIC VALUE OF ULTRASONOGRAPHY IN GESTATIONAL TROPHOBLASTIC DISEASES

作　　者：王春玲[1] 

机构地区：[1]北京大学首钢医院超声医学科,北京100144

出　　处：《齐鲁医学杂志》2015年第3期303-305,共3页Medical Journal of Qilu

摘　　要：目的探讨超声对妊娠滋养细胞疾病的诊断及临床应用价值。方法回顾分析经病理证实的71例妊娠滋养细胞疾病病人超声声像图特征。结果葡萄胎病变局限于宫腔,内充满大小不等的蜂窝状或片状无回声,彩色多普勒显示宫腔内多无血流信号,宫壁血流信号较正常妊娠者稍丰富,宫壁阻力指数(RI)为0.58±0.06,呈高阻,子宫动脉RI为0.72±0.11。恶性病变肌层或其他部位出现浸润灶,多呈低弱回声,彩色多普勒肌层血流信号异常丰富,频谱多普勒显示RI呈低阻,子宫动脉RI为0.64±0.10,肌层病灶RI为0.39±0.05,肌层无回声区周边多出现动静脉瘘。有效化疗后病灶减小,回声逐渐增强,血流信号减少,RI逐步恢复正常,肌层病灶RI为0.56±0.07。71例病人超声诊断符合率92.96%(66/71),误诊5例,占7.04%(5/71)。结论超声检查在妊娠滋养细胞疾病的早期诊断、疗效观察及随访中有较高的实用价值。Objective To assess the value of ultrasonography in the diagnosis of gestational trophoblastic diseases （GTDs）. Methods Ultrasonographic features of 71 patients with GTDs confirmed by pathology were retrospectively analyzed. Results Hydatidiform mole, the lesion was confined to cavity of uterus, filling with honeycomb or flake echoless. Color Doppler showed mostly no signals of blood flow within the uterine cavity, and blood flow signals in uterine wall were slightly riches than normal pregnancy. The resistance index （RI） of the uterine wall was 0.58＋0.06, and RI of uterine artery was 0.72＋0.11. In ma- lignant diseases, infiltrative lesions appeared in muscular layer or other parts, mostly with faint echo. Color Doppler showed blood signals were unusually rich in muscular layer, and spectral Doppler indicated low resistance index. Uterine artery RI was 0.64 ± 0.10, and muscular lesion RI was 0.39±0.05. Arteriovenous fistula was commonly seen around echo-free zone of muscular layer. After effective chemotherapy, the lesions became smaller, echo enhanced gradually, blood signals reduced and the resistance index gradually returned to normal, muscle wall RI was 0.56±0.07. The accordance rate of diagnosis in the 71 patients was 92.96% （66/ 71）, diagnostic error in five patients. Conclusion Ultrasonography has a higher practical value in regard to early diagnosis, its observation of curative effect and follow-up of gestational trophoblastic diseases.

关 键 词：妊娠滋养细胞疾病 超声检查 多普勒 诊断 

分 类 号：R737.3[医药卫生—肿瘤]