Preliminary Diagnosis: Choriocarcinoma/Molar Preganancy
I. What imaging technique is first-line for this diagnosis?
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Ultrasound with Doppler interrogation
II. Describe the advantages and disadvantages of this technique for diagnosis of choriocarcinoma/molar pregnancy.
Advantages
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Quick
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Inexpensive
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Fairly specific and sensitive
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Requires no ionizing radiation
Disadvantages
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Difficult to assess for extrauterine and extrapelvic metastases
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Not as specific as MRI
III. What are the contraindications for the first-line imaging technique?
No contraindications
IV. What alternative imaging techniques are available?
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MRI with and without contrast
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CT of the abdomen and pelvis with and without contrast
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of choriocarcinoma/molar pregnancy.
MRI with and without contrast
Advantages
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Better demonstrates the boundaries of myometrium and tumor than does CT
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Requires no ionizing radiation
Disadvantages
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Expensive
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Time consuming
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Requires significant patient cooperation to minimize motion artifact
CT of the abdomen and pelvis with and without contrast
Advantages
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Sensitive and specific for diagnosis
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Quick
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Less expensive than MRI
Disadvantages
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Exposure to ionizing radiation
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Exposure to iodinated contrast
VI. What are the contraindications for the alternative imaging techniques?
MRI with and without contrast
Absolute contraindication is non-MR-compatible hardware.
CT of the abdomen and pelvis with and without contrast
Relative contraindication during pregnancy
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