Contrast-enhanced dynamic MR imaging of postmolar gestational trophoblastic disease.
Conventional spin-echo (SE) and contrast-enhanced dynamic MR imaging were performed on a 1.5 T superconductive unit for evaluation of myometrial lesions in postmolar gestational trophoblastic disease (GTD) in 10 women. MR imaging was done at the time of the initial examination (n = 10), during (n = 6), and after repeated courses of chemotherapy (n = 10). The T2-weighted SE image revealed an enlarged uterus (n = 7), disappearance of zonal anatomy (n = 6), and heterogeneous signal intensities (n = 8) with prominent flow voids (n = 7). However, these abnormalities remained after repeated courses of chemotherapy, when the S-beta-HCG level returned to the normal range. Myometrial lesions characteristically had marked enhancement with areas of unenhancement on dynamic MR images in patients with highly elevated S-beta-HCG. Areas of contrast enhancement correlated with changes in S-beta-HCG level. The enhancement was reduced with decrease in S-beta-HCG level after repeated courses of chemotherapy. Six of 8 masses seen on T2-weighted images proved to be active trophoblastic lesions and 2 masses proved to be hematoma or necrosis. In 2 patients, abnormal myometrial lesions were detected only on contrast-enhanced dynamic MR imaging. These preliminary data indicate that contrast-enhanced dynamic MR imaging more clearly demonstrates myometrial involvement of postmolar GTD than conventional SE imaging.
Yamashita
Y
Y
Department of Radiology, Kumamoto University School of Medicine, Japan.
Torashima
M
M
Takahashi
M
M
Mizutani
H
H
Miyazaki
K
K
Matsuura
K
K
Okamura
H
H
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D006063:Chorionic Gonadotropin / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human; D003287:Contrast Media; D003609:Dactinomycin / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D002820:Hydatidiform Mole, Invasive / Q000175:diagnosis* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008727:Methotrexate / Q000008:administration & dosage; D009215:Myometrium / Q000473:pathology*; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives; D010446:Peptide Fragments / Q000097:blood; D011247:Pregnancy; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000188:drug therapy
D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D003287:Contrast Media; D009942:Organometallic Compounds; D010446:Peptide Fragments; D003609:Dactinomycin; D004369:Pentetic Acid; D019786:Gadolinium DTPA; D008727:Methotrexate