Further observations on the sonographic spectrum of gestational trophoblastic disease

Abstract

Sonograms of 27 patients with gestational trophoblastic disease were evaluated and categorized to newer concepts regarding the pathology and pathogenesis of this disorder. The patients were assigned to the following subgroups: 1) classical or complete mole; 2) partial or incomplete mole; 3) coexistent mole and fetus; 4) hydropic degeneration of the placenta; 5) locally invasive mole; and 6) metastatic trophoblastic disease, including choriocarcinoma. The utility of this categorization and of ultrasound in the diagnosis and subsequent management of these patients is presented.

Doppler study of myometrium in invasive gestational trophoblastic disease

“…In our point of view, color Doppler sonography can be used in defining those subsets. The noninvasive ultrasound has become the leading tool in the detection of GTD after its advent ( 26–28 ) . Doppler ultrasound has the additional capability in assessing the vascularity and circulatory resistance of blood flow, thus offering the advantage of providing simultaneous data on structure and function.…”

Serial Color Doppler Flow of Uterine Vasculature Combined with Serum β-hCG Measurements for Improved Monitoring of Patients with Gestational Trophoblastic Disease

“…Note the decline in PI levels when MTX administration was needed. Although ultrasonography remains the leading tool in the detection of GTD [3,4,12], Doppler technology offers additional advantages since it provides simultaneous data on structure and function [5][6][7][8][9]. Spectral analysis of the uterine and intratumoral vessels have revealed increased diastolic flow distal to the sampling point, indicating a highly vascularized tumoral bed.…”

“…Gestational trophoblastic disease (GTD) is a term commonly applied to a spectrum of trophoblastic disor ders including hydatidiform and invasive moles and cho riocarcinoma [1], Elevated serum (3-human chorionic go nadotropin ((3-hCG) levels combined with the pathogno monic 'snowstorm' sonographic appearance are extreme ly suggestive of the presence of hydatidiform mole, even before histologic material is available for final diagnosis [2], Moreover, GTD has been classified by its sonographic features and accurately correlates with the clinical and pathologic findings [3,4], Transvaginal ultrasound and color Doppler flow offer additional reliable modalities for assessing the pregnant uterus and pelvic vessels. Areas of neovascularization, which are characteristic features of GTDs, present an important target for investigation, management and fol low-up of patients presenting with these disorders [5][6][7][8][9],…”

A comparison of colour Doppler sonography and the pelvic arteriogram in assessment of patients with gestational trophoblastic disease

“…A number of imaging techniques have evolved in recent years: real‐time ultrasound (Fleischer et al 1978; Requard & Mettler 1980; Munyer et al 1981; Woo et al 1985), magnetic resonance imaging (Powell et al 1986), and Doppler ultrasound (Long et al 1990, 1992; Hsieh et al 1994; Chan et al 1994b). All of these noninvasive techniques have been applied in the study of these trophoblastic tumours, with varying success.…”