The clinical value of colour Doppler ultrasonography in diagnosis of uterine carcinosarcoma / 复旦学报（医学版）

ABSTRACT

Objective To explore the clinical value of color Doppler ultrasonography in the diagnosis of uterine carcinosarcoma (UCS).Methods The clinical data and ultrasonographic manifestations of 63 cases of UCS proved by operation and pathology in Obstetrics and Gynecology Hospital of Fudan University from January 2003 to December 2014 were retrospectively analyzed.The clinical features and characteristics of ultrasound images in UCS were summarized and classified according to their ultrasonographic features.Results It mostly occurred in postmenopausal women (77.8％).The average age of the 63 patients of UCS was (57.7 ± 11.5) years old.The most common symptoms of UCS were postmenopauseal vaginal bleeding (57.1％),menstrual disorders (20.6％),vaginal discharge (11.1％),uterine mass or thickened endometrium (11.1％).Tumor marker CA125 was evaluated in 36 women and found to be elevated in 15 women (41.7％),60％ of which (9/15) was less than 200 U/mL.Six cases (16.7％) of relative higher level of serum CA125 (＞ 200 U/mL) were at advanced stage or with malignant ovarian tumors.The sonographic findings of UCS had three typesUterine cavity type (71.4％),endometrium type (14.3％),and myometrium type (14.3％).The ultrasonographic characteristics of uterine cavity type and myometrium type were fuzzy boundary,irregular shape,and internal uneven echo.Color doppler flow image showed rich blood signals and low resistance index (0.55 + 0.11) of the surrounding and internal artery of the lesions.The large volume of lesion was the characteristic of myometrium type.Conclusions UCS is a very aggressive and extremely rare tumor with the symptoms of postmenopauseal vaginal bleeding,menstrual disorders,vaginal discharge,et al.There are three types of sonographic findings of UCSuterine cavity type,endometrium type and myometrium type.To strengthen the understanding of UCS and combined with clinical manifestations,the transvaginal color Doppler ultrasound was helpful to early detection,early diagnosis and making the appropriate treatment.