Prömpeler H J, Madjar H, Sauerbrei W, Lattermann U, Pfleiderer A
Universitäts-Frauenklinik, Albert-Ludwigs-Universität Freiburg.
Geburtshilfe Frauenheilkd. 1996 Jul;56(7):345-50. doi: 10.1055/s-2007-1023266.
Transvaginal sonomorphologie and colour Doppler measurements were obtained preoperatively in 212 adnexal tumours: 81 premenopausal tumours (13 malignant and 68 benign) and 131 postmenopausal tumours (55 vs 76). Tumours were divided into five different scores according to their sonomorphology [16]. Scores I and II are related to benign tumours. Score V represents typically malignant tumours. Scores III and IV are associated with benign and malignant tumours. If score I and II are considered as benign and score III to V as malignant the sensitivity in pre- and postmenopausal tumours is 90%. However, the specificity is only 56% vs 70% respectively. In order to improve the accuracy, colour Doppler was additionally performed in tumours with sonomorphological score III and IV. The following criteria were tested: minimum resistance index (Rlmin), number of tumour arteries (ART), maximum (Smax) and sum (Ssum) of peak systolic velocities. All criteria showed significant differences between benign and malignant tumours. Tumours of score III and IV were differentiated by colour Doppler with an accuracy between 66% and 81% for premenopausal and 69% to 86% for postmenopausal women. The combination of sonomorphology and colour Doppler increased the accuracy between 84% and 90% with a sensitivity of up to 92% in pre- and 89% in postmenopausal patients. Sequential colour Doppler sonography as a supplement to transvaginal sonography improves tumour differentiation. The limitation of colour Doppler measurements to score III and IV lesions reduced the length of examination time to a reasonable extent.
对212例附件肿瘤患者在术前进行了经阴道超声形态学和彩色多普勒测量：81例绝经前肿瘤（13例恶性和68例良性）以及131例绝经后肿瘤（55例恶性和76例良性）。根据肿瘤的超声形态学将其分为五个不同的评分等级[16]。I级和II级与良性肿瘤相关。V级通常代表恶性肿瘤。III级和IV级与良性和恶性肿瘤都有关。如果将I级和II级视为良性，III级至V级视为恶性，那么绝经前和绝经后肿瘤的敏感性均为90%。然而，特异性分别仅为56%和70%。为了提高准确性，对超声形态学评分为III级和IV级的肿瘤额外进行了彩色多普勒检查。测试了以下标准：最小阻力指数（Rlmin）、肿瘤动脉数量（ART）、收缩期峰值速度最大值（Smax）和总和（Ssum）。所有标准在良性和恶性肿瘤之间均显示出显著差异。超声形态学评分为III级和IV级的肿瘤通过彩色多普勒进行鉴别，绝经前女性的准确率在66%至81%之间，绝经后女性的准确率在69%至86%之间。超声形态学和彩色多普勒相结合使准确率提高到84%至90%，绝经前患者的敏感性高达92%，绝经后患者的敏感性为89%。序贯彩色多普勒超声作为经阴道超声的补充可改善肿瘤的鉴别诊断。将彩色多普勒测量局限于III级和IV级病变在一定程度上缩短了检查时间。
