Aleem F, Pennisi J, Zeitoun K, Predanic M
Department of Obstetrics and Gynecology, Brookdale Hospital, Brooklyn, NY 11212.
Ultrasound Obstet Gynecol. 1995 Jan;5(1):51-4. doi: 10.1046/j.1469-0705.1995.05010051.x.
The aim of this study was to characterize the appearance of the vascular pattern of endometriomas in terms of color Doppler and to verify the role of Doppler flow indices in differentiating endometriomas from other pelvic masses. Twenty patients with suspected endometriosis were referred for evaluation and surgical management of adnexal masses and/or infertility problems. Before surgery, transvaginal sonography was performed using an Ultramark 9 (ATL) Ultrasound system. The color Doppler was used for evaluation of the vascular color distribution. Flow parameters (resistance index (RI) and pulsatility index (PI) were obtained using pulsed Doppler. A total of 24 masses were identified in the 20 patients studied. Sixteen masses proved to be endometriomas, with a mean size of 3.5 +/- 0.4 cm. Of confirmed endometriomas, 81% had a regular internal surface and 63% showed the characteristic homogeneous low-level echoes filling the cyst. Eleven of 16 (69%) endometriomas showed flow by color Doppler. The flow was characteristically limited, with few spots of vascular color seen in each mass. Cases that showed dense vascularity with color Doppler proved not to be endometriomas. The mean +/- SE of the RI and PI for the endometriomas were 0.59 +/- 0.02 and 0.95 +/- 0.1, respectively. All endometriomas showed an RI of > 0.5 with a range of 0.5-0.74, while the PI was 0.59-1.59. No significant differences between flow indices for endometriomas and other benign cystic lesions were noted. Scattered vascularity, one feature of adnexal endometriomas, may help to differentiate them from other lesions of dense vascular distribution, such as corpora lutea or ovarian neoplasms.
本研究的目的是根据彩色多普勒描述卵巢巧克力囊肿血管模式的表现，并验证多普勒血流指数在鉴别卵巢巧克力囊肿与其他盆腔肿块中的作用。20例疑似子宫内膜异位症患者因附件肿块和/或不孕问题接受评估及手术治疗。手术前，使用Ultramark 9（ATL）超声系统进行经阴道超声检查。采用彩色多普勒评估血管颜色分布。使用脉冲多普勒获取血流参数（阻力指数（RI）和搏动指数（PI））。在研究的20例患者中共发现24个肿块。16个肿块被证实为卵巢巧克力囊肿，平均大小为3.5±0.4 cm。在确诊的卵巢巧克力囊肿中，81%的囊肿内表面规则，63%的囊肿显示囊肿内充满特征性均匀低回声。16个卵巢巧克力囊肿中有11个（69%）在彩色多普勒检查时显示有血流信号。血流信号特征性地局限，每个肿块中可见少量血管颜色斑点。彩色多普勒显示血管丰富的病例经证实并非卵巢巧克力囊肿。卵巢巧克力囊肿的RI和PI的平均值±标准误分别为0.59±0.02和0.95±0.1。卵巢巧克力囊肿与其他良性囊性病变的血流指数之间未发现显著差异。附件区卵巢巧克力囊肿的一个特征性表现——散在血管分布，可能有助于将其与其他血管分布密集的病变，如黄体或卵巢肿瘤相鉴别。
