Levine D, Feldstein V A, Babcook C J, Filly R A
Department of Radiology, University of California, San Francisco 94143-0628.
AJR Am J Roentgenol. 1994 Jun;162(6):1355-9. doi: 10.2214/ajr.162.6.8191998.
Current research suggests that the resistive index of adnexal masses is a sensitive measure for distinguishing between benign and malignant ovarian masses. We devised a study to determine how morphologic findings on sonograms compare with the resistive index of benign and malignant lesions.
Pelvic sonograms were obtained in 34 women with 36 adnexal masses that were likely neoplastic or non-self-limiting (such as an endometrioma). Transabdominal and transvaginal sonograms were obtained, and the resistive index was calculated. A threshold resistive index of 0.4 was used to differentiate benign from malignant lesions. Masses were characterized prospectively as probably benign or possibly malignant on the basis of their sonographic appearance. Pathologic proof was obtained for 35 masses, and one mass was diagnosed on the basis of CT findings.
Seventeen lesions were deemed probably benign, and pathologic examination showed that all 17 were benign. The resistive index was greater than 0.4 in 14 of these 17 cases. Nineteen lesions were characterized as possibly malignant. On pathologic examination, six were benign neoplasms, five were nonneoplastic masses, and eight were malignant neoplasms. The resistive index was greater than 0.4 in 10 of the 11 benign lesions. It was less than 0.4 in only two of the eight lesions that were classified as malignant on the basis of both morphologic and pathologic findings.
Sonography is sensitive but not specific for distinguishing between benign and malignant ovarian neoplasms. Although use of the resistive index might improve specificity in the assessment of possibly malignant lesions, reliance on this parameter is potentially misleading, as six of eight malignant lesions in this series were miscategorized on the basis of their resistive index.
当前研究表明，附件包块的阻力指数是区分卵巢良性和恶性包块的一项敏感指标。我们设计了一项研究，以确定超声检查的形态学表现与良性和恶性病变的阻力指数相比情况如何。
对34名患有36个附件包块的女性进行盆腔超声检查，这些包块可能为肿瘤性或非自限性（如子宫内膜瘤）。获取经腹和经阴道超声图像，并计算阻力指数。采用阻力指数阈值0.4来区分良性和恶性病变。根据超声表现，前瞻性地将包块分为可能良性或可能恶性。35个包块获得了病理证实，1个包块根据CT检查结果确诊。
17个病变被认为可能是良性的，病理检查显示所有17个均为良性。这17例中有14例阻力指数大于0.4。19个病变被判定为可能是恶性的。病理检查显示，6个为良性肿瘤，5个为非肿瘤性包块，8个为恶性肿瘤。11个良性病变中有10个阻力指数大于0.4。在8个根据形态学和病理检查结果均被分类为恶性的病变中，只有2个阻力指数小于0.4。
超声检查在区分卵巢良性和恶性肿瘤方面敏感但不具有特异性。虽然使用阻力指数可能会提高对可能恶性病变评估的特异性，但依赖该参数可能会产生误导，因为本系列中8个恶性病变中有6个根据其阻力指数被错误分类。
