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題名 | Application of Sonohysterography in the Diagnosis and Management of Abnormal Intrauterine Vascular Lesions and Persistent Elevation of Serum β-hCG=應用子宮輸卵管超音波造影術於異常絨毛性腺激素與子宮血管病變之研究 |
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作 者 | 施景中; 徐明洸; 王文中; 黃千祝; 周輝政; 陳皙堯; 謝豐舟; | 書刊名 | Journal of Medical Ultrasound |
卷期 | 6:2 1998.06[民87.06] |
頁次 | 頁74-80 |
分類號 | 417.143 |
關鍵詞 | 子宮輸卵管; 超音波造影術; 異常絨毛性腺激素; 子宮; 血管病變; Sonohysterography; Gestational trophoblastic tumor; Abortion; Ultrasound; |
語文 | 英文(English) |
英文摘要 | Background: Persistent intrauterine vascular lesions can present a challenge and dilemma in diagnosis and management, especially when the serum concentration of the β -subunit of human chorionic gonadotropin (β -hCG) remains elevated. The currently used work-up, which includes color Doppler ultrasound, serum β -hCG determination and magnetic resonance imaging, is not always sufficiently specific to distinguish between gestational trophoblastic tumors and other nonmalignant conditions of pregnancy. Materials and Methods: Sixteen patients with intrauterine echogenic tumor and a persistent elevation of serum β -hCG were investigated. Color Doppler ultrasound depicted abundant low-resistance blood flow within the lesions in all cases, but the location and nature of the tumors could not be differentiated, using either conventional ultrasound or β -hCG assays. The patients were further evaluated using saline infusion sonohysterography (SHG). Results: Using saline infusion SHG, these lesions were identified as intracavitary (n = 9) and intramural (n = 7). Those patients with intracavitary lesions underwent subsequent uneventful evacuation and the pathology results confirmed the diagnosis of nonmalignant conditions of pregnancy. The intramural lesions were suspected of being gestational trophoblastic tumors. These patients were given a complete staging work-up and treated with an appropriate chemotherapeutic protocol. All of these patients attained complete remission after four to six courses of chemotherapy. Conclusion: Saline infusion SHG is a safe and effective procedure in differentiating between intramural gestational trophoblastic tumor and other nonmalignant conditions of pregnancy. Its use can facilitate appropriate intervention in cases of abnormal intrauterine vascular lesions with persistent β -hCG levels. |
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