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目的探讨经阴道彩色多普勒超声(TVCDU)对绒癌的诊断和疗效随访价值。方法回顾性分析本院2003-05～2004-07共21例绒癌患者的TVCDU报告和相关的临床资料。结果绒癌的声像图表现可归结为以下几种类型:(1)子宫增大,局部肌层出现不规则暗区,CDFI提示为血池;(2)肌层内不均低回声块,边界隐约可见,无包膜,血流丰富,阻力指数RI0.25～0.47;(3)宫腔不均回声团,与肌层分界欠清,可探及血流,RI约0.4;(4)附件区低回声包块,血流较丰富,RI<0.5;(5)子宫附件未及明显异常。其声像图改变和初次绒毛膜促性腺激素(HCG)值之间的关系较复杂。但随访中发现:随化疗疗程的进展而病灶缩小,RI升高者,血HCG下降较明显。结论经阴道彩超在绒癌的诊断、鉴别诊断及在随访时评价疗效等过程中都有非常重要的作用。
Objective To investigate the value of transvaginal color Doppler ultrasound (TVCDU) in the diagnosis and treatment of choriocarcinoma. Methods Retrospective analysis of our hospital from May 2003 to 2004-07 a total of 21 cases of choriocarcinoma TVCDU report and related clinical data. Results The findings of choriocarcinoma can be attributed to the following types: (1) enlarged uterus, irregular dark area in the local myometrium and CDFI suggestive of blood pool; (2) uneven hypoechoic mass in the muscular layer, The border is vaguely visible, with no capsule and abundant blood flow. The resistance index RI0.25 ~ 0.47; (3) The unequal uterine cavity and the muscular layer are not clear enough to detect blood flow, RI is about 0.4; (4) Annex area hypoechoic mass, blood flow is richer, RI <0.5; (5) uterine appendages without obvious abnormalities. The relationship between sonographic changes and initial chorionic gonadotropin (HCG) values is more complicated. However, follow-up found: with the progress of chemotherapy and lessening of the lesion, RI, blood HCG decreased significantly. Conclusion Transvaginal ultrasound in choriocarcinoma diagnosis, differential diagnosis and follow-up evaluation of the efficacy of the process has a very important role.