DiSantis D J, Scatarige J C, Kemp G, Given F T, Hsiu J G, Cramer M S
Department of Radiology, DePaul Medical Center, Eastern Virginia Medical School, Norfolk 23505.
AJR Am J Roentgenol. 1993 Jul;161(1):91-4. doi: 10.2214/ajr.161.1.8517330.
Despite the expanding role of transvaginal sonography in routine gynecologic examinations, as well as in screening for ovarian cancer, recent reports have noted problems when using the procedure for detecting ovarian masses and visualizing the ovaries in postmenopausal women. Our study was designed to assess prospectively the capability of transvaginal sonography in evaluating the ovary and detecting adnexal masses.
Transvaginal sonography was used to examine 113 ovaries in 59 women within 72 hr before gynecologic surgery. Ovarian size and echo texture were assessed, and a search was made for adnexal masses. Sonograms were interpreted without knowledge of the clinical history or results of physical examination, and the sonographic findings were compared with surgical and pathologic data.
In the 22 premenopausal patients, 16 (76%) of 21 histologically normal ovaries were identified on sonograms, but only 13 (59%) of 22 adnexal masses. Lesions as large as 177 cm3 were not detected. In the 37 postmenopausal patients, 12 (20%) of 59 normal ovaries and six (54%) of 11 adnexal masses were identified. Five malignant masses (largest, 113 cm3) were not detected.
In this selected population, our ability to detect normal postmenopausal ovaries and ovarian masses was suboptimal in a number of cases. Practitioners should be aware of potential limitations in the use of this technique alone to evaluate the ovary.
尽管经阴道超声检查在常规妇科检查以及卵巢癌筛查中的作用不断扩大，但最近的报告指出，在使用该检查方法检测绝经后妇女的卵巢肿块和观察卵巢时存在问题。我们的研究旨在前瞻性评估经阴道超声检查评估卵巢和检测附件肿块的能力。
在妇科手术前72小时内，使用经阴道超声检查对59名女性的113个卵巢进行检查。评估卵巢大小和回声质地，并寻找附件肿块。在不了解临床病史或体格检查结果的情况下解读超声图像，并将超声检查结果与手术和病理数据进行比较。
在22名绝经前患者中，21个组织学正常的卵巢中有16个（76%）在超声图像上被识别出来，但22个附件肿块中只有13个（59%）。体积达177立方厘米的病变未被检测到。在37名绝经后患者中，59个正常卵巢中有12个（20%）以及11个附件肿块中有6个（54%）被识别出来。5个恶性肿块（最大体积为113立方厘米）未被检测到。
在这个特定人群中，我们在许多情况下检测绝经后正常卵巢和卵巢肿块的能力并不理想。从业者应意识到仅使用该技术评估卵巢时存在的潜在局限性。
