Division of Gynecologic Oncology, Department of Obstetrics and Gynecology and the Department of Biostatistics, the University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, Kentucky.
Obstet Gynecol. 2013 Aug;122(2 Pt 1):210-217. doi: 10.1097/AOG.0b013e318298def5.
To examine the prevalence, incidence, persistence, and resolution of ovarian abnormalities using serial transvaginal ultrasonography.
A group of 39,337 women in the University of Kentucky Ovarian Cancer Screening Program were monitored with 221,576 baseline and interval transvaginal ultrasonography.
The transvaginal ultrasonogram was normal for first and all subsequent visits for 31,834 participants (80.9%), whereas 6,807 women (17.3%) had transvaginal ultrasonograms interpreted as abnormal and were monitored over 21,588 ultrasonograms. Ovarian cysts were more common in premenopausal (prevalence 34.9%, incidence 15.3%) than in postmenopausal women (prevalence 17.0%, incidence 8.2%). For the group with abnormalities, the initial transvaginal ultrasonogram was abnormal in 46.7% of the cases, of which 63.2% resolved to normal on subsequent ultrasonograms. Of 35,314 cases classified as normal on the first examination, 9.9% were abnormal on subsequent annual examinations. The abnormal findings were classified as follows: unilocular cysts (11.5%), cysts with septations (9.8%), cysts with solid areas (7.1%), and solid masses (1.8%). Many transvaginal ultrasonographic abnormalities were followed to resolution. Surgery was performed on 557 participants for 85 ovarian malignancies and 472 nonmalignancies. Over the duration of the study, the positive predictive value (PPV) increased from 8.1% to 24.7%.
Serial ultrasonography has shown that many ovarian abnormalities resolve, even if the initial appearance is complex, solid, or bilateral. Thus, it is advantageous to avoid a single transvaginal ultrasonographic abnormality as the sole trigger for surgery and to take a measured serial approach to reduce false-positive results and increase the PPV.
II.
通过经阴道超声检查，研究卵巢异常的发生率、持续性和转归。
肯塔基大学卵巢癌筛查计划中的 39337 名女性接受了 221576 次基线和间隔经阴道超声检查。
31834 名参与者（80.9%）的经阴道超声检查结果首次和所有后续检查均正常，而 6807 名妇女（17.3%）的经阴道超声检查结果异常，并接受了 21588 次超声检查监测。绝经前妇女卵巢囊肿更为常见（发生率 34.9%，发病率 15.3%），而绝经后妇女发生率较低（发生率 17.0%，发病率 8.2%）。对于异常组，初始经阴道超声检查异常的病例占 46.7%，其中 63.2%在后续超声检查中恢复正常。在首次检查正常的 35314 例中，9.9%在随后的年度检查中异常。异常发现分为以下几类：单房性囊肿（11.5%）、有分隔的囊肿（9.8%）、有实体区域的囊肿（7.1%）和实性肿块（1.8%）。许多经阴道超声异常可随诊至消失。557 名参与者因 85 例卵巢恶性肿瘤和 472 例非恶性肿瘤接受了手术。在研究期间，阳性预测值（PPV）从 8.1%增加到 24.7%。
连续超声检查显示，即使初始表现复杂、实性或双侧，许多卵巢异常也会消退。因此，避免将单次经阴道超声异常作为手术的唯一触发因素，并采取谨慎的连续方法，可以减少假阳性结果并提高 PPV。
II 级。
