经阴道超声对侵蚀性葡萄胎的早期及精准诊断的预期观察  

Prospective observation of early diagnosis and accurate diagnosis of invasive mole by transvaginal ultrasound

作　　者：苏娜[1] 姜玉新[1] 戴晴[1] 杨萌[1] 张波[1] 张冰[1] 赵辰阳[1] 王铭[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院超声诊断科,100730

出　　处：《中华医学超声杂志（电子版）》2017年第2期99-104,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金(81301268);北京市科技新星计划(Z131107000413063)

摘　　要：目的深度探讨侵蚀性葡萄胎的超声声像图特点,观察有无特异性超声征象,旨在对侵蚀性葡萄胎的早期诊断及精准诊断提供更多诊断依据。方法对20例于2014年1月至2016年1月在北京协和医院经临床综合诊断确诊为侵蚀性葡萄胎的初治患者进行经阴道超声检查,全面观察超声动态图像,以期发现侵蚀性葡萄胎的早期超声声像图特点及特异性超声征象。结果经阴道超声在20例患者中发现4例直径<2.0 cm的病灶,表现为在葡萄胎清宫术后,子宫肌层内出现异常不均质回声,伴有局部血流信号明显增多紊乱;在8例患者子宫肌层病灶中观察到水肿绒毛的囊状无回声水泡结构。结论葡萄胎清宫术后,在子宫肌层内发现血流异常丰富区域有助于早期诊断侵蚀性葡萄胎。子宫肌层病灶中发现囊状无回声水泡结构有助于精准诊断侵蚀性葡萄胎,并可与绒毛膜癌相鉴别。Objective To explore the characteristics of sonographic patterns of invasive mole （IM）, observe specific ultrasonic signs and provide more evidences for early and precise diagnosis of IM. Methods Twenty patients diagnosed with IM at the PUMC Hospital from 2014 January to 2016 January were evaluated by transvaginal ultrasonography. These sonographic dynamic images were observed comprehensively and carefully in order to discover the early ultrasound characteristics and specific ultrasonic representations of IM. Results It was indicated by transvaginal ultrasonography that there were myometrial lesions in 4 patients with diameters less than 2.0 cm, performing as heteroechoic lesions in myometrium with obviously increased and disorder blood flow signals after the curettage of uterine cavity. Meanwhile, the myometrial lesions of 8 patients showed hydropic ftuid-filled molar vesicles, representing swollen villi. Conclusions After the curettage of uterine cavity, presentations of the myometrial lesions with abnormally rich blood flow contribute to early diagnosis of IM. And the patterns of myometrial hydropic fluid-filled molar vesicles can play an important role in the accurate diagnosis of IM, and may distinguish it from choriocarcinoma.

关 键 词：超声检查 葡萄胎 侵蚀性 早期诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]