Clinical Value Of Two-dimension Ultrasound And Color Doppler Flow Image In Diagnosing Ovarian Neoplasms

By analysing 170 cases of ovarian neoplamas proved bypathology and operation, the clinical value of two-dimentionultrasound and color Doppler flow image in diagnosing ovarianneoplasms were discussed..Materials and method170 cases of ovarian neoplasms proved by pathology andoperation were examined by ultrasound, aged18-78,In Jan.2001-Oct.2004, among them ,benign tumor was 110cases,aged 36.7±9.3,malignant tumor was 60cases, aged 50.2±14.9.All the cases were examined by Acuson 128XP/10 machine , theabdominal probe frequency is 3.5MHz, patients filled bladder first.The tumor in addexa was examined routinely by two-dimensionultrasound: include size, figure, amiculum, internal structure andascites. The focus was watched carefully to see blood flow insideand outside, then multiple sample of tumor's vessel was taken toget clear color Doppler ultrasonography scoring and theminimum resistance index.Result1 Observing the characristics of ovarian neoplasms bytwo-dimension ultrasound :There are 119 tumors among 110 casesof benign tumor, 111 tumors have amiculums, 98 tumors havecomplete and regular amiculums, cyst walls are smooth, 84tumors show cystic; while there 65 tumors among 60 cases ofmalignant tumor, only 23 of them have amiculums, among them14 have uncomplete amiculums, 47 tumors show solid tumorwith cystic component inside, they two have apparent statisticalmeanings. 2 Ascites can be detected in 32 cases among 60 patients withmalignant ovarian tumor, account for 53%, only 2 cases withascites be found in benign tumors. 3 There are 110 benign tumors among 170cases, 39casesshow blood flow, the average CDUS is 2.89±1.01,the average RIis 0.61±0.09; There 60 cases of malignant tumor,58cases showblood flow, the average CDUS is 6.2±2.01, the average RI is 0.4±0.04. The two average numbers have apparent statisticalmeanings. 4 The diagnostic sensitivity ,specificity and accuracy can beenhanced by using CDUSand RI together in diagnosing benignand malignant tumors. Discussion There are many kinds of ovarian neoplasms, among themthe death rate of malignant ovarian tumor is the highest one .Inrecent years ,the morbidity is tend to increase, because the tumorwas often found in advanced stage, the patients'prognosis is bad.Their survival rate depend on the tumor's stages and historicaldiffertiation. Finding the malignant tumor earlier make theoperation possible ,and make the prognosis better. Two-dimensionand color Doppler flow image are the first selection in diagnosingovarian neoplasms. The different forms of tumors can be found in different partsand growing styles, this characristic can be used as basis todiagnose tumors. The two-dimension ultrasound can detect thetumor's size, forms, physical feature, and is the basis ofdifferentiation of neoplasms. Benign tumour almost grow inexpanding way , having clear boundary and also have completeamiculums; while the malignant ones grow fast, most showirregular form with uncomplete amiculums or appear unclearly;most of benign tumor are cystic;while malignant tumor are solidor solid with cystic component inside. The proportion of solidwith cystic component inside and half cyst half solid amongbenign and malignant tumor is nearly the same, but the solid partof malignant tumor was often show different intensity echo ,falsenegative appeared more often among malignant tumor in mainlycomposed of cyst than that of mainly composed of solid part,which should be pay much attention. Ascites often be seen among malignant tumors. In commonsense, ascites is caused by tumor surface's implantation orsecreted by tumor cell which metastasized to peritoneum, orcaused by stimuli from decomposed products. Ascites has positiverelationship with the degrees of malignant neoplasms. Therefore,whenever ascites be seen under ultrasound, malignant tumorshould be in consideration; also no ascites could not exclude thetendency of malignancy. In this condition further examination isnecessary by using CDFI to detect blood flow. In addtion, ascitesin malignant and benign tumor should be distinguished CDFI can detect the distribution and figure of blood flowof the neoplasms, it can supply more diagnostic informationthan that of two-dimention ultrasound, it plays a special role indistinguishing malignant and benign ovarian tumor. Theheterotype of benign tumor is less than that of malignant ones,most of them grow slowly with fewer newly vessel; whilemalignant tumor grow faster, with more newly vessels, and morearteries and veins anastomosis and lack of muscle tissue invascular wall lead to declined resistance index. Thedistribution characteristic of blood flow in malignant tumor isthat they scattered diffusely within septa or inside solid parts,while the number of vessles in benign tumor is much less thanthat of malignant ones, and most of them located around the focus ,lacking of blood vessel is the feature of benign tumor. Because ofthe malignant tumor and benign tumor have their own featureson vessel-forming and blood-supplying, their blood flow...