Differential Diagnosis Of High Risk Factors And CT, MR Of Hydatidiform Mole

Objective:In recent years, the mortality and morbidity of trophoblastic tumor increased significantly,causing a serious threat to women’s health. Hydatidiform mole belongs to benign trophoblastic disease, with a certain tendency to malignant transformation, due to improper treatment or other factors can lead to the change of hydatidiform mole choriocarcinoma and invasive mole.The main work in this paper is to investigate the relevant factors of induced malignant transformation of hydatidiform mole and evaluation of CT and MR in the diagnosis of early malignant change in hydatidiform mole of clinical application.Design and experiment method:(Ⅰ) Subject to prosecution choice:The clinical data of 100 patients with hydatidiform mole in our hospital in 2010 January to2014 January for the retrospective study. The selected patients were by the pathological science examination confirmed the diagnosis of hydatidiform mole and in further before treatment with CT and MRI. The follow-up time between 1 to 2 years. Were grouped according to the grouping criteria: the high-risk group of 70 cases and non high risk group(30 cases), age from 19 to 47 years, average age was 31.4 years.(Ⅱ)Subject to the prosecution prepared:(1) Before CT examination preparation: for married patients, before inspectionapplication gauze packing into the vagina, in 1 hour before scanning, about oral iodine solution 600 ml, enjoin patient urine, bladder filling good fully display the intestinal.(2) Before MR examination preparation: before the examination of drinking water to the bladder filling good, bladder and adjacent structures of the contrast enhancement. At the same time, the training patients breath.(Ⅲ) CT, MR inspection method:(1) CT examination: the equipment: Philips Brilliance16 row CT. Of all patients were conventional enhanced scan and CT scan, enhanced scan, for patients with intravenous injection of iohexol, the concentration of 2ml / kg, injection speed 3ml / s, 85 seconds after injection start scanning, when necessary to do about 3mm thin slice reconstruction and interval, layer thickness is 5mm; in addition to the need to Toshiba asteion with Daul double row CT.(2) MR examination: the Siemens Magnetom trio,, Erlangen, Germany3.0T magnetic resonance instrument and the body surface coil, including coronary position and axial STIR sequence scanning(IT80ms, TE42 ms, TE) axial and coronary position, sagittal T2 WI TE85ms te, axial T1 WI TE25ms TR550 ms, matrix scan for 192 * 256, FOV32 cm, thickness 6mm, layer from 7mm, the reconstruction matrix 512 * 512.(Ⅳ) Data processing:(1) Major risk factors: hydatidiform mole whether or not repeated, luteinized cyst size, pregnancy, age, compared with high risk factors and no risk factors of patients with hydatidiform mole malignant transformation rate.(2) CT and MRI of malignant change of hydatidiform mole in different image study forms were identified, two check in is the malignant transformation of advantages and disadvantages.(Ⅴ) Image analysis:The selected clinical confirmed malignant hydatidiform mole, that have high risk factors of malignant transformation of hydatidiform mole and does not have the risk factors of patients with hydatidiform mole CT and MRI materials and basic medical history were analyzed.(Ⅵ) Comparison of the risk factors of malignant transformation rate statistics, rank sum test usingstatistical analysis, the difference was statistically significant P < 0.05.Results:1. In a study of 100 cases of hydatidiform mole patients, 70 patients with high risk factors and 30 cases of patients with no risk factors, patients with high risk factors of malignant transformation of hydatidiform mole rate was significantly higher than that of no risk factors of patients with hydatidiform mole.(1) Lutein cyst of ovary than 6cm in patients with malignant cyst was significantly higher than that of less than 6cm patients.(2) The uterus is equal to or greater than the gestational age of the patients with malignant transformation rate was significantly higher than that in patients with gestational age less than.(3) At the time of menopause for more than 2 weeks in patients with canceration rate was significantly higher than that in 2 weeks following the patients.(4) Over the age of 40 patients with canceration rate was significantly higher than that of patients under 40 years of age.2, All patients with malignant imaging:(1) CT findings of invasive hydatidiform mole has certain characteristics: mainly for the uterus increases, thickening of the muscle, enhanced muscular layer of low density lesions in and local vascular increased thickening, thin slice reconstruction display in the muscular layer of small cystic shadows. Familiar with the characteristics of CT for the assessment ofhydatidiform mole and early invasive mole predictive evaluation can help.(2) MRI can clearly display the uterine cavity and uterus muscle layer is affected by the invasion and pelvic, hydatidiform mole and invasive mole MRI has characteristic manifestations, hydatidiform mole tissue penetrated uterine flesh layer is key to the differential diagnosis of and provide guidance for clinical treatment.