[The value of nuclear magnetic resonance tomography in diagnosing invasive trophoblast disease].
13 patients between 19 and 35 years, 12 of them with histologically verified trophoblastic disease, were examined by MRI, to prove the diagnostic value of this method. In line with the excellent results of MRI described in the literature with respect to the differentiation of tissue characterisation, vascularisation and localisation of tumours, the response to chemotherapy was evaluated comparatively to HCG-titres (5 patients). The results showed, that a decrease of HCG-titres correlated with significant tumour reduction. MRI was performed with 1.5 Tesla machines. Axial, sagittal and coronal images of pelvis and abdomen in T1, proton density and T1 sequences, one after administration of Gd-DTPA, were carried out. Except for one case with decreasing titres, GTP was proven by MRI. The tumour showed a remarkable lack of homogeneity and signal increase in 7 cases in T2-weighted images. In one case, the tumour showed a marked signal enhancement after applying Gd-DTPA, compared with the normal myometrium. In 5 cases, destruction of the zonal anatomy of the uterus and dilatation of subserosal uterine and pelvis veins were found. The uterus was larger in size than expected for the duration of gravidity. In correlation with the clinical examination and HCG titres, MRI has the potential of multiplanar imaging and signal characterisation of tissue, and is therefore useful to evaluate the tumour extent and to detect residuals. Gradient echo-technique and the use of contrast media will reduce the duration of examination, but more experience is required.
Helweg
G
G
Abteilung für Röntgendiagnostik und Computertomographie, Universität Innsbruck.
Pessar
M
M
Wicke
K
K
Marth
C
C
Sief
R
R
zur Nedden
D
D
Furtschegger
A
A
D000328:Adult; D002822:Choriocarcinoma / Q000175:diagnosis / Q000473:pathology; D006063:Chorionic Gonadotropin / Q000097:blood; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis / Q000473:pathology; D008279:Magnetic Resonance Imaging; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating; D009942:Organometallic Compounds; D004369:Pentetic Acid; D011247:Pregnancy; D014328:Trophoblastic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014599:Uterus / Q000473:pathology
D006063:Chorionic Gonadotropin; D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA
Der Stellenwert der Kernspintomographie in der Diagnostik invasiver Trophoblasterkrankungen.