CT evaluation of invasive trophoblastic disease

We report the use of dynamic CT for the evaluation of trophoblastic disease of the uterus. In five cases showing evidence of persistent trophoblastic disease after evacuation of a molar gestation, contrast enhancement of the myometrium demonstrated several hypodense foci surrounded by highly enhanced areas. These observations were not found in two cases of successfully evacuated hydatidiform mole without sequela. A case of choriocarcinoma showed a large central nonenhanced lesion with peripheral contrast enhancement. Filling defects in a markedly contrast enhanced lesion probably represent hydatids penetrating the myometrium and should suggest invasive mole.