CT Chest A variety of pulmonary complications may be evaluated using chest CT [44,45], including trophoblastic tumor thrombus, associated lung infarct, and secondary pulmonary arterial hypertension. Unusual manifestations of lung metastases may be perceptible such as an endobronchial lesion with secondary obstruction and volume loss. Airspace disease and pleural effusion may follow hemorrhage into parenchymal and intravascular metastases [44,45]. Because detection of these complications may require opacification of the vessels, IV contrast enhancement is necessary to improve lesion conspicuity, although hemorrhagic complications would be visible on an unenhanced study. CT Head Craniotomy with surgical decompression is generally indicated for acute symptomatic treatment of patients with intracranial hemorrhage [16]. CT can be used to identify and localize lesions or to detect signs of increased intracranial pressure and mass effect in patients with acute neurologic symptoms and signs of deterioration. Hemorrhagic complications and structural changes related to mass effect would be visible without IV contrast, although lesion detection would be improved with IV contrast. CT Abdomen and Pelvis CT is indicated to detect metastatic disease in the staging of patients with GTN, but can also be used to identify sites of active hemorrhage or other tumor-related complications [74]. Liver metastases can be associated with catastrophic intraperitoneal hemorrhage and may require selective angiographic embolization techniques [16]. Use of CT abdomen and pelvis should be prompted by abdominopelvic location of patient symptoms in context of known GTN. Hemorrhagic complications would be evident without the use of IV contrast. IV contrast may be required to detect individual nonhemorrhagic lesions. MRI Head Craniotomy with surgical decompression is generally indicated for acute symptomatic treatment of patients with intracranial hemorrhage [16].
Gestational Trophoblastic Disease. CT Chest A variety of pulmonary complications may be evaluated using chest CT [44,45], including trophoblastic tumor thrombus, associated lung infarct, and secondary pulmonary arterial hypertension. Unusual manifestations of lung metastases may be perceptible such as an endobronchial lesion with secondary obstruction and volume loss. Airspace disease and pleural effusion may follow hemorrhage into parenchymal and intravascular metastases [44,45]. Because detection of these complications may require opacification of the vessels, IV contrast enhancement is necessary to improve lesion conspicuity, although hemorrhagic complications would be visible on an unenhanced study. CT Head Craniotomy with surgical decompression is generally indicated for acute symptomatic treatment of patients with intracranial hemorrhage [16]. CT can be used to identify and localize lesions or to detect signs of increased intracranial pressure and mass effect in patients with acute neurologic symptoms and signs of deterioration. Hemorrhagic complications and structural changes related to mass effect would be visible without IV contrast, although lesion detection would be improved with IV contrast. CT Abdomen and Pelvis CT is indicated to detect metastatic disease in the staging of patients with GTN, but can also be used to identify sites of active hemorrhage or other tumor-related complications [74]. Liver metastases can be associated with catastrophic intraperitoneal hemorrhage and may require selective angiographic embolization techniques [16]. Use of CT abdomen and pelvis should be prompted by abdominopelvic location of patient symptoms in context of known GTN. Hemorrhagic complications would be evident without the use of IV contrast. IV contrast may be required to detect individual nonhemorrhagic lesions. MRI Head Craniotomy with surgical decompression is generally indicated for acute symptomatic treatment of patients with intracranial hemorrhage [16].