MAGNETIC-RESONANCE-IMAGING IN PATIENTS WITH GESTATIONAL TROPHOBLASTICDISEASE

RATIONALE AND OBJECTIVES. The authors describe the magnetic resonance (MR) imaging characteristics in patients with gestational trophoblasti c disease (GTD) before and after therapy and to correlate these findin gs with human gonadotropin levels and the specific histology of GTD. M ETHODS. Thirteen women (mean age, 30.1 years) with elevated human chor ionic gonadotropin (HCG) levels and histologically proven GTD underwen t MR examinations of the pelvis, Magnetic resonance imaging was perfor med on a 1.5-tesla unit, Axial and sagittal proton density-weighted an d T2-weighted and sagittal TI-weighted sequences were obtained, Four p atients underwent follow-up studies after 4 and 8 weeks to monitor the response to therapy, Gestational trophoblastic disease was histologic ally proven with curettage in II patients and with hysterectomy in two cases, RESULTS. Nine patients had a diffusely enlarged uterus with pa thologic signal intensities, In four patients, a focal tumor mass was observed, All patients showed loss of the zonal anatomy of the uterus in at least one local area, In 11 patients, no uterus zones could be i dentified throughout the entire uterus, Pathologic dilated tumor vesse ls were evident in all patients, In all four cases in which follow-up imaging studies were obtained, uterus size, signal intensities, identi fication of uterus zones, and uterus vessels returned to normal,CONCLU SION. Magnetic resonance imaging shows trophoblastic tumor infiltratio n as diffuse uterus enlargement, focal tumor masses, loss of zonal ana tomy of the uterus, and pathologic uterine vasculature; this seems to be the most reliable MR imaging finding in patients with GTD, No corre lation was found between MR imaging changes and HCG levels or specific histologic types of GTD.