Sawicki W, Spiewankiewicz B, Cendrowski K, Stelmachów J
I Department of Obstetrics and Gynecology, II Faculty of Medical Academy Warsaw, Poland.
Clin Exp Obstet Gynecol. 1995;22(2):137-42.
Since early detection of ovarian cancer is difficult, most cases are diagnosed at advanced stages. The imaging diagnosis is based on pattern classification and is limited with respect to the precise determination of malignancy. High-frequency transvaginal sonography improves the ability to detect malignant ovarian tumors over that of transabdominal route, however, the predictive values are unsatisfactory because of inability to distinguish between malignant and benign tumors that have similar morphologic characteristics. The introduction of transvaginal colour flow imaging has allowed detection of low-resistance intratumoral blood vessels, characteristic of malignant tumors, and visually reflected the state of blood flow of an ovarian tumor. These two ultrasonographic methods were used for diagnosis of ovarian tumors in 65 women treated in our Department of Obstetrics and Gynecology. Waveforms of the parenchymal tumor arteries or tumor surface arteries were compared using value of the resistance index (RI). The sensitivity, specificity and accuracy of the preoperative RI in detecting malignant ovarian tumors were 100%, 94%, 95.4% respectively. The sensitivity, specificity and accuracy of preoperative suspicious sonographic findings in detecting malignant ovarian tumors were 100%, 61% and 71%. Positive and negative predictive values of colour flow imaging were 85% and 100%, whereas for grey-scale transvaginal ultrasonography they were 46% and 100% respectively. The findings of this study suggest that transvaginal colour Doppler is a method which is superior to the other methods for preoperative evaluation of ovarian malignancy.
由于卵巢癌早期检测困难，大多数病例在晚期才被诊断出来。影像学诊断基于模式分类，在精确判定恶性肿瘤方面存在局限性。高频经阴道超声检查比经腹途径提高了检测恶性卵巢肿瘤的能力，然而，由于无法区分形态特征相似的恶性和良性肿瘤，其预测价值并不令人满意。经阴道彩色血流成像的引入使得能够检测到恶性肿瘤特有的低阻力肿瘤内血管，并直观地反映卵巢肿瘤的血流状态。这两种超声检查方法用于对我院妇产科治疗的65例女性卵巢肿瘤进行诊断。使用阻力指数（RI）值比较实质肿瘤动脉或肿瘤表面动脉的波形。术前RI检测恶性卵巢肿瘤的敏感性、特异性和准确性分别为100%、94%、95.4%。术前可疑超声检查结果检测恶性卵巢肿瘤的敏感性、特异性和准确性分别为100%、61%和71%。彩色血流成像的阳性和阴性预测值分别为85%和100%，而灰阶经阴道超声检查的阳性和阴性预测值分别为46%和100%。本研究结果表明，经阴道彩色多普勒检查是一种在术前评估卵巢恶性肿瘤方面优于其他方法的检查方法。
