Stukan Maciej, Bugalho Antonio, Kumar Amanika, Kowalewska Julita, Świetlik Dariusz, Buda Natalia, Pietrzak-Stukan Małgorzata, Dudziak Mirosław
Department of Gynecologic Oncology, Gdynia Oncology Center, Pomeranian Hospitals, 81-519 Gdynia, Poland.
CUF Infante Santo Hospital, CUF Descobertas Hospital, NOVA Medical School, 1350-070 Lisbon, Portugal.
Diagnostics (Basel). 2020 Feb 5;10(2):85. doi: 10.3390/diagnostics10020085.
A detailed transabdominal and transvaginal ultrasound examination, performed by an expert examiner, could render a similar diagnostic performance to computed tomography for assessing pelvic/abdominal tumor spread disease in women with epithelial ovarian cancer (EOC). This study aimed to describe and assess the feasibility of lung and intercostal upper abdomen ultrasonography as pretreatment imaging of EOC metastases of supradiaphragmatic and subdiaphragmatic areas. A preoperative ultrasound examination of consecutive patients suspected of having EOC was prospectively performed using transvaginal, transabdominal, and intercostal lung and upper abdomen ultrasonography. A surgical-pathological examination was the reference standard to ultrasonography. Among 77 patients with histologically proven EOC, supradiaphragmatic disease was detected in 13 cases: pleural effusions on the right (n = 12) and left (n = 8) sides, nodular lesions on diaphragmatic pleura (n = 9), focal lesion in lung parenchyma (n = 1), and enlarged cardiophrenic lymph nodes (n = 1). Performance (described with area under the curve) of combined transabdominal and intercostal upper abdomen ultrasonography for subdiaphragmatic areas (n = 77) included the right and left diaphragm peritoneum (0.754 and 0.575 respectively), spleen hilum (0.924), hepatic hilum (0.701), and liver and spleen parenchyma (0.993 and 1.0 respectively). It was not possible to evaluate the performance of lung ultrasonography for supradiaphragmatic disease because only some patients had this region surgically explored. Preoperative lung and intercostal upper abdomen ultrasonography performed in patients with EOC can add valuable information for supradiaphragmatic and subdiaphragmatic regions. A reliable reference standard to test method performance is an area of future research. A multidisciplinary approach to ovarian cancer utilizing lung ultrasonography may assist in clinical decision-making.
由专业检查人员进行的详细经腹和经阴道超声检查，在评估上皮性卵巢癌（EOC）女性患者盆腔/腹部肿瘤播散性疾病方面，可能具有与计算机断层扫描相似的诊断性能。本研究旨在描述和评估肺部及肋间上腹部超声检查作为EOC膈上和膈下区域转移瘤术前成像的可行性。对连续怀疑患有EOC的患者进行术前超声检查，采用经阴道、经腹、肋间肺部及上腹部超声检查。手术病理检查是超声检查的参考标准。在77例经组织学证实为EOC的患者中，检测到13例膈上疾病：右侧（n = 12）和左侧（n = 8）胸腔积液、膈胸膜结节性病变（n = 9）、肺实质局灶性病变（n = 1）和心膈角淋巴结肿大（n = 1）。经腹和肋间上腹部联合超声检查对膈下区域（n = 77）的性能（用曲线下面积描述）包括左右膈腹膜（分别为0.754和0.575）、脾门（0.924）、肝门（0.701）以及肝脾实质（分别为0.993和1.0）。由于仅部分患者对该区域进行了手术探查，因此无法评估肺部超声检查对膈上疾病的性能。对EOC患者进行术前肺部及肋间上腹部超声检查可为膈上和膈下区域提供有价值的信息。测试方法性能的可靠参考标准是未来研究的一个领域。利用肺部超声检查对卵巢癌采取多学科方法可能有助于临床决策。
