Background. Destruction of uterine vasculature is a common phenomenon in gestational trophoblastic tumors. The authors categorized such uterine vasculature by color Doppler ultrasound and studied its clinical significance.
Methods. Color Doppler ultrasound was performed in 28 patients with gestational trophoblastic tumors. The vascular morphologic manifestations were recorded, and the peak systolic velocity and resistance index of uterine artery were calculated. Serum beta-human chorionic gonadotropin (hCG) levels were measured periodically to monitor chemotherapy response. Seventeen uneventful postmole uteri were used as controls. Two-tailed Student's t-test and Fisher's exact test were used for statistical analysis.
Results. The gestational trophoblastic tumors were categorized as diffuse type (N = 7), lacunar type (N = 16), and compact type (n = 5) according to their vascular patterns. The mean serum beta-hCG level at diagnosis in diffuse type lesions (6608 f 6320 mIU/mL) was significantly lower than in the lacunar type (40462 ? 39735 mIU/mL; P = 0.04) and compact type (212114 k 205126 mIU/mL; P = o.OZ), whereas the level in compact type lesions was significantly higher than in the lacunar type (P = 0.003). Lacunar type lesions exhibited a significantly lower uterine artery resistance index (0.51 * 0.13) than diffuse type (0.66 k 0.10; P = 0.03) or compact type lesions (0.70 ? 0.06; P = 0.02). All lesions exhibited significantly higher peak systolic velocity than control subjects [P < 0.001); however, no significant difference was observed among them. Brief courses (< 5 cycles) of chemotherapy From the Departments of