Fleischer A C, Rodgers W H, Rao B K, Kepple D M, Worrell J A, Williams L, Jones H W
Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232-2675.
J Ultrasound Med. 1991 Oct;10(10):563-8. doi: 10.7863/jum.1991.10.10.563.
This report describes the results of transvaginal color Doppler sonography (TV-CDS) of 43 surgically proved ovarian masses. Waveform analyses of the signals arising from specific vessels (i.e., peripheral, central, septal) adjacent to and within these masses were correlated to those seen on macroscopic pathologic evaluation. The mean and standard deviation of the pulsatility indices (PI) of 32 benign lesions (1.8 +/- 0.8) were higher than 11 malignant ones (0.8 +/- 0.6) (P = 0.03). However, the range of benign (4.0 to 0.7) and malignant (1.5 to 0.4) lesions did overlap. Low PIs (less than 1.0) were found in five relatively benign lesions (one case each of dermoid cyst, cystadenoma containing a dermoid cyst, endometrioma, benign sclerosing stromal tumor, and thecoma), but also in all 11 malignant or borderline malignant lesions (nine cystadenocarcinomas, two germ cell tumors), causing an overlap between the PIs of some benign and malignant masses. With a 100% negative predictive value, our preliminary data suggest that TV-CDS can effectively exclude malignancy. However, with a positive predictive value of 73%, one in four malignant lesions diagnosed by TV-CDS will be benign.
本报告描述了对43例经手术证实的卵巢肿块进行经阴道彩色多普勒超声检查（TV-CDS）的结果。对这些肿块内部及周围特定血管（即周边、中央、间隔血管）产生的信号进行波形分析，并与宏观病理评估结果进行关联。32例良性病变的搏动指数（PI）平均值及标准差为（1.8±0.8），高于11例恶性病变的（0.8±0.6）（P = 0.03）。然而，良性病变（4.0至0.7）和恶性病变（1.5至0.4）的范围存在重叠。在5例相对良性的病变（皮样囊肿、含皮样囊肿的囊腺瘤、子宫内膜瘤、良性硬化性间质瘤和卵泡膜细胞瘤各1例）中发现低PI（小于1.0），但在所有11例恶性或交界性恶性病变（9例囊腺癌、2例生殖细胞肿瘤）中也发现低PI，导致一些良性和恶性肿块的PI出现重叠。我们的初步数据显示，TV-CDS具有100%的阴性预测值，提示其可有效排除恶性病变。然而，其阳性预测值为73%，即经TV-CDS诊断为恶性的病变中，每4例就有1例实际为良性。
