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Duplex ultrasonography for persistent gestational trophoblastic tumor
G R Dobkin1, R S Berkowitz, D P Goldstein
1Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115.
The Journal of Reproductive Medicine
|January 1, 1991
Summary
Doppler ultrasonography effectively detects persistent gestational trophoblastic tumor (GTT) after molar pregnancy. This imaging technique shows higher sensitivity than standard ultrasound for diagnosing GTT, aiding in timely patient management.
Area of Science:
- Reproductive Medicine
- Diagnostic Imaging
- Gynecologic Oncology
Background:
- Persistent gestational trophoblastic tumor (GTT) requires accurate diagnosis following molar pregnancy evacuation.
- Elevated or plateauing beta-human chorionic gonadotropin (hCG) levels indicate potential residual GTT.
- Conventional imaging may have limitations in detecting subtle GTT.
Purpose of the Study:
- To evaluate the diagnostic performance of duplex ultrasonography, including imaging and Doppler, for persistent uterine GTT.
- To compare the sensitivity of sonographic imaging versus Doppler flow assessment in identifying GTT.
- To determine the complementary role of imaging and Doppler in GTT diagnosis.
Main Methods:
- Duplex ultrasonography (imaging and Doppler) was performed on 17 patients with suspected persistent GTT.
- Abnormal sonographic findings included altered echogenicity; abnormal Doppler indicated intrauterine blood flow.
- Ultrasound results were correlated with pathological findings from dilation and curettage specimens.
Main Results:
- Of 10 patients with macroscopic GTT, 7 had abnormal imaging (70% sensitivity) and 9 had abnormal Doppler (90% sensitivity).
- All 10 patients with macroscopic GTT showed abnormalities with either imaging or Doppler, or both.
- For microscopic disease, imaging detected GTT in 1 of 4 cases, while Doppler detected it in 3 of 4 cases.
Conclusions:
- Imaging and Doppler ultrasonography are valuable, complementary tools for detecting persistent uterine GTT.
- Doppler ultrasonography demonstrates superior sensitivity compared to standard imaging for diagnosing GTT.
- These modalities aid in the reliable detection and management of persistent GTT.