Color Doppler imaging in the sonohysterographic diagnosis of residual trophoblastic tissue.
OBJECTIVE
The purpose of this study was to evaluate the role of color Doppler imaging during sonohysterography in the diagnosis of residual trophoblastic tissue.


METHODS
This prospective cohort study involved 25 consecutive women with clinical and sonographic signs of an echogenic intrauterine mass who were referred to the sonography unit of our institution for evaluation. All women underwent saline infusion sonohysterography with color Doppler sonographic evaluation. An operative hysteroscopy with histologic examination was performed in 17 cases.


RESULTS
Thirteen women (group A) had sonohysterographic features suggestive of residual trophoblastic tissue (ie, an echogenic intrauterine lesion not detached from the uterine wall after introduction of saline). The initial diagnosis was confirmed by histologic analysis in all cases. Blood flow was detected within the intrauterine mass in 6 (46%) of these 13 women; the resistance indices were low in all 6 cases (mean +/- standard error, 0.38 +/- 0.01). Twelve women (group B) had sonohysterographic findings negative for retained tissue, and no blood flow was detected within any of the intrauterine masses in this group (p < 0.05).


CONCLUSIONS
Our results confirm the potential role of color Doppler sonography in the initial diagnosis of residual trophoblastic tissue. The detection of color Doppler signals, especially with low-resistance flow, within an intrauterine lesion should increase the confidence of the sonologist in the diagnosis of residual trophoblastic tissue.
Zalel
Yaron
Y
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Hashomer, Ramat-Gan 52621, Israel.
Gamzu
Ronni
R
Lidor
Arie
A
Goldenberg
Mordechai
M
Achiron
Reuven
R
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D018365:Neoplasm, Residual; D006473:Postpartum Hemorrhage / Q000000981:diagnostic imaging* / Q000601:surgery; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014328:Trophoblastic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D018615:Ultrasonography, Doppler, Color; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery