title: Sonographic diagnosis of gestational trophoblastic disease and comparison with retained products of conception.
abstract: OBJECTIVE
  Gestational trophoblastic disease (GTD) and retained products of conception (RPC) can be difficult to distinguish sonographically. The aim of this study was to determine whether there were any sonographic criteria that could prospectively distinguish one from the other.
  
  
  METHODS
  Institutional ethics approval was obtained, and acquisition of consent was waived by the Institutional Review Board. A retrospective review of gynecologic oncology and pathology databases identified 17 cases of GTD and 14 cases of RPC. Findings from the pre-evacuation transvaginal sonographic examinations were analyzed. The scans were independently reviewed by 2 senior radiologists with specific expertise in pelvic sonography using several predetermined sonographic features. The reviewers were blinded to the diagnosis. A consensus reading was obtained.
  
  
  RESULTS
  The sonographic features that predicted GTD were a myometrial epicenter (P = .0002; odds ratio [OR] = 28), depth of myometrial invasion of more than one third (P = .001; OR = 20), placental venous lakes (P = .04; OR = 9), maximum mass dimensions of more than 3.45 cm (P = .009), and maximum endometrial thickness of less than 12 mm (P = .02). The remaining criteria were not statistically significant and included the characteristics of the mass, ascites, a "snowstorm" appearance, mass vascularity (including resistive index and peak systolic velocity), and the presence of ovarian cysts.
  
  
  CONCLUSIONS
  There are specific transvaginal sonographic features that can accurately differentiate GTD and RPC.
authors.affiliation: Department of Medical Imaging, Sunnybrook and Women's College Hospital, University of Toronto, ON M4N 3M5, Canada. carrie.betel@sunnybrook.ca
authors.forename: Cara
authors.initials: C
authors.lastname: Betel
authors.forename: Mostafa
authors.initials: M
authors.lastname: Atri
authors.forename: Anna-Marie
authors.initials: AM
authors.lastname: Arenson
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Khalifa
authors.forename: Raymond
authors.initials: R
authors.lastname: Osborne
authors.forename: George
authors.initials: G
authors.lastname: Tomlinson
mesh_terms: D000027:Abortion, Incomplete / Q000000981:diagnostic imaging*; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D010048:Ovarian Cysts / Q000000981:diagnostic imaging*; D011247:Pregnancy; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016216:Ultrasonography, Prenatal / Q000379:methods; D014599:Uterus / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D006063:Chorionic Gonadotropin