CAJ | 학술논문

目的：应用三维能量彩色多普勒超声作为定量方法,进行诊断和评估妊娠滋养细胞疾病(GTD)临床治疗效果的可行性。方法前瞻性收集自2011年12月至2013年10月在西安交通大学医学部第一附属医院就诊并接受治疗的52例 GTD 患者以及30名健康对照。应用 VOLUSON E8仪器进行超声检查。获取阻力指数(RI)、血管化指数(VI)、血流指数(FI)以及血流血管综合指数(VFI)等超声相关指数用以进一步统计分析。结果52例 GTD 患者的超声相关指数为：子宫肌层 RI 值为0.47±0.17,显著低于健康对照(P <0.01)；子宫肌层 VI 值为(81.46±20.54)%, FI 值为67.28±20.21以及 VFI 值为58.12±25.53,显著高于健康对照(P <0.01)。三维能量彩色多普勒超声结果显示,妊娠滋养细胞肿瘤患者子宫肌层 RI 值显著低于葡萄胎患者(P <0.01),而子宫肌层 VI、FI 以及 VFI 值则显著高于葡萄胎患者(P <0.01)。在针对妊娠滋养细胞肿瘤患者进行相应的化学治疗后,三维能量彩色多普勒超声异常的相关指数均呈现恢复趋势。结论通过肿瘤血管血流相关的信息,RI、VI、FI 以及 VFI 值可以更加直观反映疾病状态,可以作为 GTD 的诊断和治疗效果评估的指标,并且具有实时性,可以提供相应的影像学资料的优势。
목적：응용삼유능량채색다보륵초성작위정량방법,진행진단화평고임신자양세포질병(GTD)림상치료효과적가행성。방법전첨성수집자2011년12월지2013년10월재서안교통대학의학부제일부속의원취진병접수치료적52례 GTD 환자이급30명건강대조。응용 VOLUSON E8의기진행초성검사。획취조력지수(RI)、혈관화지수(VI)、혈류지수(FI)이급혈류혈관종합지수(VFI)등초성상관지수용이진일보통계분석。결과52례 GTD 환자적초성상관지수위：자궁기층 RI 치위0.47±0.17,현저저우건강대조(P <0.01)；자궁기층 VI 치위(81.46±20.54)%, FI 치위67.28±20.21이급 VFI 치위58.12±25.53,현저고우건강대조(P <0.01)。삼유능량채색다보륵초성결과현시,임신자양세포종류환자자궁기층 RI 치현저저우포도태환자(P <0.01),이자궁기층 VI、FI 이급 VFI 치칙현저고우포도태환자(P <0.01)。재침대임신자양세포종류환자진행상응적화학치료후,삼유능량채색다보륵초성이상적상관지수균정현회복추세。결론통과종류혈관혈류상관적신식,RI、VI、FI 이급 VFI 치가이경가직관반영질병상태,가이작위 GTD 적진단화치료효과평고적지표,병차구유실시성,가이제공상응적영상학자료적우세。
Objective To clarify the reliability of three-dimensional power Doppler as a quantitative method in detecting gestational trophoblastic disease (GTD ) and assessing its therapeutic effect. Methods We prospectively collected a database of 52 patients with GTD diagnosed at the First Affiliated Hospital of Xi’an Jiaotong University from December 201 1 to October 2013 and 30 healthy women as controls.Sonography was performed using a Voluson E8. Resistance index (RI ), vascularization index (VI ), flow index (FI ) and vascularization-flow index (VFI)of the region of interest were collected for further analysis.Results Of the 52 GTD datasets,variation from the mean value was RI 0.47±0.1 7;VI (81.46 ±20.54)%;FI 67.28 ±20.21;and VFI 58.12±25.53.Three-dimensional power Doppler examination indicated that there were significant differences in RI,VI,FI and VFI values between healthy individuals and patients in each subgroup (P <0.01).Further,after combining invasive hydatidiform mole and choriocarcinoma groups,it also showed a significant difference between hydatidiform mole group and the combined malignant group (P <0.01).And the abnormal sonographic and power Doppler findings in GTD were resolved when chemotherapy was given successfully.Conclusion RI,VI,FI and VFI values were more related to the information of tumor blood flow,and more intuitive to manifest the status of the disease.They could be new methods in diagnosing and assessing treatment of GTD for their real-time nature.