Gestational Trophoblastic Disease: A Multimodality Imaging Approach with Impact on Diagnosis and Management
Sonographic spectrum of GTN. (a) Complex solid-cystic mass in the uterine fundus with myometrial epicenter (arrows) on sagittal TVS. Anechoic serpiginous structures in the adjoining myometrium represent increased vascularity (arrowheads). (b) Predominantly echogenic myometrial mass (arrows) effacing the zonal anatomy of uterus on Sagittal TAS. Color flow Doppler ultrasound reveals prominent vascularity in the lesion. (c) Small hypoechoic lesion (arrows) with irregular margins in the lower uterine body, disrupting the endometrial stripe and invading the adjoining myometrium on Sagittal TAS. (d) Ill-defined multicystic myometrial mass (between cursors) on transverse TVS. (e) Two round well-defined submucosal myometrial GTN lesions (arrows) with homogeneous isoechoic to hyperechoic echotexture, indenting the endometrial stripe (arrowheads) and partially effacing it on sagittal TVS, resembling submucosal fibroids. (f) An ovoid isoechoic mass with irregular margins (arrows) at endomyometrial interface on sagittal TVS simulating an adenomyoma or a submucosal fibroid. Arrowheads = endometrium (g) Enlarged uterus with a lobulated contour and heterogeneous echotexture on sagittal TVS. Arrows = cervix.