Doppler study of myometrium in invasive gestational trophoblastic disease.
OBJECTIVE
In this prospective study, we aimed to assess the prognostic and diagnostic role of color Doppler flow of myometrium in patients with invasive gestational trophoblastic disease (GTD).


METHODS
Thirty-seven patients, who were enrolled in the study with invasive mole, were assessed with the help of transvaginal color Doppler ultrasound before and after chemotherapy. The place and the size of the myometrial invasions were assessed.


RESULTS
Thirty patients of 37 were treated with the help of single-agent chemotherapy--methotrexate (mtx). In this group, the resistance index (RI) ratios ranged between 0.26 and 0.45 and the size of the myometrial invasion varied between 10 and 50 mm. On the other hand, six patients were treated with mtx and actinomycin D combination and one patient was treated with the help of total abdominal hysterectomy. In this group, the RI ratios ranged between 0.16 and 0.25 and the size of the myometrial invasion varied between 60 and 90 mm. Remission was achieved in all patients.


CONCLUSIONS
Transvaginal color Doppler study can easily detect invasive GTD. When the depth and the width of the myometrial invasion increase and when there is a low diastolic/systolic ratio, the number of courses and the need for combination of chemotherapy increase.
Oguz
S
S
Zekai Tahir Burak Women Health Education and Research Hospital, Ankara, Turkey. oguzjs@yahoo.com
Sargin
A
A
Aytan
H
H
Kelekci
S
S
Dumanli
H
H
D000293:Adolescent; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003609:Dactinomycin / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009215:Myometrium / Q000000981:diagnostic imaging* / Q000473:pathology*; D009361:Neoplasm Invasiveness; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D014621:Vagina / Q000000981:diagnostic imaging
D000903:Antibiotics, Antineoplastic; D018906:Antineoplastic Agents, Alkylating; D003609:Dactinomycin; D008727:Methotrexate