Lin Lawrence Hsu, Polizio Rodrigo, Fushida Koji, Francisco Rossana Pulcineli Vieira
University of Sao Paulo Trophoblastic Disease Center, Department of Obstetrics and Gynecology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Sao Paulo State Cancer Center, Department of Oncology and Radiology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Semin Ultrasound CT MR. 2019 Aug;40(4):332-349. doi: 10.1053/j.sult.2019.03.002. Epub 2019 Mar 5.
Gestational trophoblastic disease (GTD) is a spectrum of disorders characterized by abnormal trophoblastic proliferation. GTD includes benign conditions such as hydatidiform moles and malignant diseases that are referred as gestational trophoblastic neoplasia (GTN). Ultrasound plays a central role in the diagnosis of patients with hydatidiform mole. Other imaging modalities are useful in molar pregnancy, mainly for evaluating pulmonary complications and atypical presentation of hydatidiform mole. GTN typically arises after 20% of molar pregnancies but can uncommonly occur after nonmolar gestations. After uterine evacuation, serial human chorionic gonadotropin levels are evaluated in patients for early detection of GTN. Once GTN is suspected, Doppler ultrasound is the primary tool to confirm the diagnosis; however, magnetic resonance imaging can also help in selected cases. Metastatic disease workup can involve various modalities, including ultrasound, X-ray, computed tomography, magnetic resonance imaging and positron emission tomography/computed tomography. In this article, we review the main imaging modalities used to evaluate patients with GTD.
妊娠滋养细胞疾病（GTD）是一组以滋养细胞异常增殖为特征的疾病谱。GTD包括良性疾病，如葡萄胎，以及被称为妊娠滋养细胞肿瘤（GTN）的恶性疾病。超声在葡萄胎患者的诊断中起着核心作用。其他影像学检查在葡萄胎妊娠中也很有用，主要用于评估肺部并发症和葡萄胎的非典型表现。GTN通常发生在20%的葡萄胎妊娠之后，但在非葡萄胎妊娠后也可能罕见发生。子宫排空后，对患者进行连续的人绒毛膜促性腺激素水平评估，以早期发现GTN。一旦怀疑患有GTN，多普勒超声是确诊的主要工具；然而，磁共振成像在某些情况下也能提供帮助。转移性疾病的检查可涉及多种方式，包括超声、X线、计算机断层扫描、磁共振成像和正电子发射断层扫描/计算机断层扫描。在本文中，我们回顾了用于评估GTD患者的主要影像学检查方式。
