超声诊断葡萄胎合并妊娠49例临床分析OA北大核心CSTPCD

Objective:To study the value of ultrasound in the diagnosis and prognosis of hydatidiform mole complicated with pregnancy.Methods:49 female patients were suspected diagnosis of hydatidiform mole compli-cated with pregnancy by ultrasound in West China Second University Hospital from January 2014 to April 2023.According to the pathological results,the cases were divided into the hydatidiform mole group(20 cases)and the benign lesion group(25 cases).The ultrasound examination and clinical characteristics of the two groups were analyzed.The Cohen's Kappa statistic was used for measuring agreement of ultrasound images by different doc-tors.Results:①Among the 49 cases,31 cases chose to terminate pregnancy,14 cases chose to continue preg-nancy,and 4 cases were lost to follow-up.45 patients obtained definite pathological results,and 4 cases with com-plete hydatidiform mole,16 with partial hydatidiform mole.The other 25 cases were benign lesions,including 5 ca-ses of placental mesenchymal dysplasia,4 cases of placental and chorionic villi abnormal,2 cases of placental ad-hesion,1 case of placental infarction,et al.The accuracy of ultrasound in the diagnosis of hydatidiform mole com-plicated with pregnancy was about44.4%(20/45).②Compared with the benign lesion group,the mass volume in the hydatidiform mole group was significantly larger,the number of anechoic lesions in the mass(>15 anechoic in one section)was significantly higher,and the size difference of single anechoic lesion(≥80%)was significantly lower.All the differences were statistically significant(P<0.05).③In this study,two sonographers interpreted the ultrasound images of hydatidiform mole complicated with pregnancy,and all the ultrasound interpretation results of Kappa were above 0.75.Conclusions:The larger the volume of the mass,the more the number of anechoic le-sions(>15 in one section)and the more consistent the size of anechoic distribution in the mass,the more likely diagnosed as hydatidiform mole complicated with pregnancy.Ultrasound findings of benign diseases such as pla-cental mesenchymal dysplasia are also confused with hydatidiform mole and should be cautious.Although the ac-curacy of ultrasound diagnosis is limited,timely detection of abnormality is facilitated for clinical management.