Bonilla-Musoles F, Ballester M J, Simon C, Serra V, Raga F
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Valencia, Spain.
J Ultrasound Med. 1993 Jan;12(1):33-9. doi: 10.7863/jum.1993.12.1.33.
A total of 108 cases of small perimenopausal ovarian tumors (largest diameter, less than 7 cm) were evaluated by transvaginal sonography and duplex color Doppler sonography; 101 had criteria for benignity and 7 for malignancy. All cysts were punctured and aspirated to avoid unnecessary surgery (benign cases) and establish the cytologic diagnosis as well as to avoid the risk of leakage (malignant cases). Recurrence rate of benign punctured cysts was 25% within 1 year of follow up. No difference in recurrent rate was seen between pre- and postmenopausal patients (19 of 56 cases in the premenopausal group, and five of 28 cases in the postmenopausal group). The larger the cyst, the greater the risk of recurrence. Puncture and aspiration of seven sonographically established malignant tumors allowed cytologic diagnosis before surgery, and no evidence of leakage was noted at the time of surgery. No significant differences were observed between cytologic and histopathologic findings in cases that went to surgery. Puncture and aspiration of small endometriomas (17 cases) was found to be inefficient for therapeutic purposes. Finally, owing to the high percentage of unsatisfactory cytologic results (20%) with cyst aspiration, vaginal and color Doppler sonography seemed more efficient in distinguishing between benignity and malignancy.
对108例围绝经期小卵巢肿瘤（最大直径小于7cm）进行经阴道超声和双功彩色多普勒超声检查；其中101例符合良性标准，7例符合恶性标准。对所有囊肿进行穿刺抽吸，以避免不必要的手术（良性病例）并确立细胞学诊断，同时避免渗漏风险（恶性病例）。穿刺的良性囊肿在随访1年内的复发率为25%。绝经前和绝经后患者的复发率无差异（绝经前组56例中有19例复发，绝经后组28例中有5例复发）。囊肿越大，复发风险越高。对7例超声诊断为恶性的肿瘤进行穿刺抽吸，可在手术前确立细胞学诊断，手术时未发现渗漏迹象。接受手术的病例中，细胞学和组织病理学结果之间未观察到显著差异。发现穿刺抽吸小的子宫内膜瘤（17例）治疗效果不佳。最后，由于囊肿抽吸的细胞学结果不满意率较高（20%），阴道超声和彩色多普勒超声在鉴别良恶性方面似乎更有效。
