27 set. trofoblástica gestacional; dois relataram mola hidatiforme completa, dois às evoluções da doença trofoblástica gestacional, cinco artigos. (2)Rio de Janeiro Trophoblastic Disease Center, Associação Brasileira de Doença Trofoblástica Gestacional, Rio de Janeiro, RJ, Brazil. RESUMO Doença trofoblástica gestacional inclui um grupo interrelacionado de doenças originadas do tecido placentário, com tendências distintas de invasão.

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Doenca Trofoblastica Gestacional

These metastatic liver lesions are not easily distinguished from other hypervascular liver tumors. Ultrasound is the firstline examination in the diagnosis of molar pregnancy.

The PI of the uterine artery is an indirect measure of functional vasculature of the tumor, being considered trofoblastia predictor of resistance to chemotherapy, especially to methotrexate, regardless of the FIGO score In the gestadional of uterine arteries during the first trimester of a normal pregnancy, Doppler egstacional studies show high impedance wave patterns with low diastolic velocities, except at the placental implantation site.

Many vessels are visualized in all MRI scans. Other, rarer, radiographic changes have also been associated with GTN, including pleural effusion, interlobular septal thickening, cavitations, and air bronchogram Gadolinium contrast-enhanced MRI scan of the pelvis, showing, hypointense lesions with avid uptake and vascular dilation in the myometrium, sometimes in close contact with the uterine effusion, in patients treated for GTN.

In such cases, ultrasound is mandatory in order to exclude this form of reproductive counterfeiting Certain signs and symptoms of hydatidiform mole have become uncommon because the systematic use of ultrasound has resulted in the early first-trimester detection of pregnancy.

Surgery and radiotherapy are necessary in some patients with high-risk GTN, especially in those with chemoresistance. Angiography in GTN Conventional angiography can be used for the embolization of vestacional and liver metastases. Fast MR imaging in obstetrics. Imaging practices in the diagnosis and management of gestational trophoblastic disease: Cochrane Database Syst Rev.

Doppler flow studies in GTN Color and spectral Doppler flow studies are used together with an ultrasound gray scale in the assessment of GTN and in its post-treatment follow-up Acta Obstet Gynecol Scand.


It is usually accompanied by malformation of the gestational sac or of the fetus, which can have characteristics such as hydrocephalus, syndactyly, cleft lip, and growth restriction If there is liver involvement, the lesions are usually multiple, heterogeneous, and hypointense, with a high avidity gestcional intravenous contrast in the arterial phase Figure 9and hemorrhagic transformation is common. Low risk of relapse after achieving undetectable HCG levels in women with partial molar pregnancy.

The image is improved by contrast administration 2,20, In such cases, partial hydatidiform mole with trisomy is differentiated by identifying a separate, normal, placenta 1,2, The patient evolved to liver rupture, hemoperitoneum, and death.

Other conditions can have a similar appearance, such conditions including the presence of residual trophoblastic tissue from a miscarriage or ectopic pregnancy, pelvic inflammatory disease, other uterine malignancies, diverticulitis or appendicitis with uterine abscesses, and uterine arteriovenous malformations Therefore, careful monitoring of hCG and contraception are essential.

In the second trimester, the anechoic spaces increase in number and size, thus facilitating the diagnosis, gestavional that made by transabdominal ultrasound Services on Demand Journal. The initial assumption is invasive mole.

Doença trofoblástica gestacional complicada por hemorragia

Note the absence of embryonic tissue and its attachments. In rare cases, there is adnexal torsion with acute vascular abdomen or rupture that results in hemoperitoneum, both of which call for immediate treatment Prognostic markers and longterm outcome of placental-site trophoblastic tumours: In the brain, there are typically multiple lesions, primarily located in the parietal lobe at the junction between the white and gray matter.

After being diagnosed, patients with GTD should be evaluated at a referral center for its treatment, where the uterine contents can be evacuated by vacuum aspiration 1,2. In most cases of GTN, cure can be achieved 4.

The presence of foci with hyperintense signals is probably due to hemorrhagic foci within the lesion. Placental site trophoblastic tumor: On CT, GTN confined to the uterus can be described as a low-attenuation lesion within an enlarged uterus Gestational trophoblastic disease is an abnormality of pregnancy that encompasses a group of diseases that differ from each other in their propensity for regression, invasion, metastasis, and recurrence.


Some cases of mole show nonspecific alterations on Doppler flow studies, although ultrasound is more widely used in the evaluation of cases of GTN 2, CT of the abdomen showing three hypointense, hypovascular lesions with peripheral enhancement in a patient with GTN.


When combined with Doppler flow studies, it is useful not only in the evaluation of GTN but also in the evaluation of the response to treatment and in the detection trofoblasstica GTN recurrence. Gestational trophoblastic disease; Hemorrhagic complications; Chemotherapy. It is known that a low PI indicates a higher number of arteriovenous communications and trrofoblastica neovascularization. Contrast-enhanced T1-weighted images can show a mass with a signal equal to or slightly more intense than that of the adjacent myometrium, containing small, distributed diffusely cystic spaces, reflecting the vesicular nature of the tumor Studies have shown that nodules can persist after effective chemotherapy, without affecting the prognosis Contrast-enhanced CT of the chest, acquired during follow-up, showing numerous metastatic lung lesions.

Human chorionic gonadotropin and associated molecules. Radiol Clin North Am. Pleural, endovascular, and endobronchial lesions have also been described 2. Metastases derived from choriocarcinoma are characteristically hypervascular, with a tendency to bleed 2.

MR imaging of the placenta: That aberration does not allow the formation of embryonic tissue or its attachments. The treatment is the same as that used in tubal ectopic pregnancy, and the follow-up is similar to that required for intrauterine hydatidiform mole.

How to cite this article. Curr Probl Diagn Radiol.