多普勒超声对妊娠滋养细胞肿瘤疗效评估的价值

摘要

目的:探讨多普勒超声(DUS)对妊娠滋养细胞肿瘤(GTN)疗效评估的价值.方法:回顾性分析44例GTN患者化疗前后及随访期间血清绒毛膜促性腺激素(β-HCG)水平、子宫结构及多普勒血流阻力指数(RI)的变化.结果:44例化疗前DUS表现为宫旁病变1例,弥漫型5例,局限型38例;局限型病例病灶直径为(4.38±1.55) cm,44例RI 为(0.30±0.06),较对照组的(0.65±0.04)明显降低(t=27.963,P＜0.001).化疗结束病灶消失后原病灶区血流RI为(0.64±0.04),与对照组比较,差异无统计学意义(t=1.029,P=0.307).随访8~30 个月,1例化疗无效子宫切除,余43例化疗有效,血清β-HCG转阴.宫壁异常回声消失与血清β-HCG转阴同步者27例,宫壁异常回声延迟消失14例,残余病灶切除1例,失访1例.结论:DUS对GTN的随访与疗效评估有重要的临床价值.%Aim:To assess the value of Doppler ultrasonography (DUS) for chemotherapy effect of gestational tropho - blastic neoplasm( GTN).Methods: A retrospective analysis of 44 cases of GTN was performed with the examination of serum beta human chorionic gonadotropin (β-HCG) , uterine structure, and Doppler resistance index (RI) before and after chemotherapy and during the follow-up.Results: DUS showed that one case had parauterine lesion and others had uterine structure changes including 5 with diffuse type and 38 with limited form; the diameter of lumps of the limited form was (4.38 ±1.55) cm, and RI of 44 cases was (0.30 ±0.06) before chemotherapy, which was lower than that [(0.65 ± 0.04) ] of the normal control (t =27.963 ,P < 0.001).RI was (0.64 ± 0.04) after chemotherapy , which was similar to the normal control (t =1.029 ,P =0.307).During the follow-up, one case accepted hysterectomy , and other 43 cases got negative serum β-HCG; 27 cases' pelvis structure recovered with negative serum β-HCG,14 cases' pelvis structure changes delayed.Conclusion: DUS is useful in estimating the chemotherapy effect of GTN .