Imafuku Hitomi, Miyahara Yoshiya, Ebina Yasuhiko, Yamada Hideto
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
Kobe J Med Sci. 2018 May 28;64(1):E1-E5.
Both twin pregnancies with complete hydatidiform mole and coexisting normal fetus (CHMCF) and partial hydatidiform mole can be found in association with a live fetus and a placenta displaying a molar degeneration. Two cases of CHMCF using magnetic resonance imaging (MRI) for a diagnosis are reported.
In the first, CHMCF was suspected at 12 weeks of gestation. At 18 weeks of gestation, the existence of molar placenta and a sac separating from fetus and normal placenta was clearly depicted on MRI. At 19 weeks of gestations, she had termination of pregnancy because of a development of gestational trophoblastic neoplasia (GTN) and started chemotherapy. In the second case, CHMCF was suspected at 14 weeks of gestation. MRI demonstrated the existence of molar placenta and a sac separating from fetus and normal placenta. She chose induced abortion and there was no evidence of GTN during the 1 year-follow up period. Pathological examination in both cases was consistent with a complete hydration mole and a coexisting normal female fetus.
MRI was useful for an accurate diagnosis for CHMCF.
双胎妊娠中，完全性葡萄胎合并正常胎儿（CHMCF）以及部分性葡萄胎均可与活胎及表现为葡萄样变性的胎盘同时存在。本文报告了两例采用磁共振成像（MRI）进行诊断的CHMCF病例。
第一例，妊娠12周时怀疑为CHMCF。妊娠18周时，MRI清晰显示存在葡萄胎胎盘以及一个与胎儿和正常胎盘分离的囊腔。妊娠19周时，因妊娠滋养细胞肿瘤（GTN）进展而行终止妊娠，并开始化疗。第二例，妊娠14周时怀疑为CHMCF。MRI显示存在葡萄胎胎盘以及一个与胎儿和正常胎盘分离的囊腔。她选择了人工流产，在1年的随访期内未发现GTN证据。两例的病理检查均符合完全性水泡状胎块及并存的正常女性胎儿。
MRI对CHMCF的准确诊断有用。
