Testa A C, Timmerman D, Exacoustos C, Fruscella E, Van Holsbeke C, Bokor D, Arduini D, Scambia G, Ferrandina G
Gynecologic Oncology Unit, Catholic University of Sacred Heart, Rome, Italy, and Department of Obstetrics and Gynecology, University Hospital Katholieke Universiteit Leuven, Belgium.
Ultrasound Obstet Gynecol. 2007 May;29(5):512-6. doi: 10.1002/uog.4013.
To describe sonographically the distribution patterns of a second-generation contrast agent in the microcirculation of unilocular and multilocular ovarian masses with papillary projections, and to investigate whether qualitative evaluation of the passage of the contrast agent can improve the performance of sonography in distinguishing between benign and malignant masses with papillary projections.
Thirty-three patients with unilocular or multilocular ovarian masses with papillary projections were enrolled into the study in three clinical centers. The contrast-enhanced transvaginal examination was performed using 'Contrast Tuned Imaging' (CnTI) technology and SonoVue ultrasound contrast agent.
Twenty-four (73%) lesions were benign, eight (24%) were borderline ovarian tumors, and one patient presented with an endometrioid ovarian adenocarcinoma. On color and power Doppler examinations the presence of vessels was demonstrated in 17 papillary projections, while on CnTI-SonoVue examination, the presence of vessels was shown in these 17 and in six additional cases. In all cases with absent papillary perfusion after SonoVue intravenous injection, the cyst wall appeared unequivocally regular. The sensitivity and specificity of conventional color Doppler examination with regard to malignancy were 100% and 67% and the positive and negative likelihood ratios were 3.03 and 0.16, respectively. For the contrast-enhanced examination the corresponding values were 100%, 42%, 1.7 and 0.26. The difference in specificity was statistically significant (P<0.05) because 14 cases, in which papillary perfusion was detected after SonoVue injection, proved to be benign on pathological examination.
Qualitative evaluation of blood circulation in papillary projections using CnTI-SonoVue examination does not improve the discrimination of benign from borderline/malignant ovarian masses with papillary projections.
通过超声描述第二代造影剂在伴有乳头状突起的单房和多房卵巢肿块微循环中的分布模式，并研究造影剂通过情况的定性评估是否能提高超声鉴别伴有乳头状突起的良恶性肿块的性能。
三个临床中心招募了33例伴有乳头状突起的单房或多房卵巢肿块患者。使用“对比调谐成像”（CnTI）技术和声诺维超声造影剂进行经阴道超声造影检查。
24例（73%）病变为良性，8例（24%）为卵巢交界性肿瘤，1例患者为子宫内膜样卵巢腺癌。在彩色和能量多普勒检查中，17个乳头状突起显示有血管，而在CnTI-声诺维检查中，这17个乳头状突起以及另外6例显示有血管。在所有静脉注射声诺维后乳头状灌注缺失的病例中，囊肿壁明显规则。传统彩色多普勒检查对恶性肿瘤的敏感性和特异性分别为100%和67%，阳性和阴性似然比分别为3.03和0.16。对于超声造影检查，相应的值分别为100%、42%、1.7和0.26。特异性差异具有统计学意义（P<0.05），因为在14例声诺维注射后检测到乳头状灌注的病例中，病理检查证明为良性。
使用CnTI-声诺维检查对乳头状突起的血液循环进行定性评估并不能提高鉴别伴有乳头状突起的良性与交界性/恶性卵巢肿块的能力。
