| Objective:Two-dimensional color Doppler ultrasound-guided biopsy results of ovarian lesions in our hospital between January 2008 and December 2009 were retrospectively analyzed to investigate the Clinical value of such method in the diagnosis of Ovarian tumors and evaluate the feasibility of applying the technique in diagnosis of ovarian tumors, analysis the main cause of negative results resulted by puncture biopsy.Methods:a total of 105 patients suspected of ovarian tumour who received two-dimensional ultrasound and color Doppler ultrasound guided biopsy between January 2008 and December 2009 were chosen, the pathological diagnosis of biopsy and comprehensive surgical pathology or clinical diagnosis were compared.Results:all of the 105 patients with suspected ovarian cancer lesions were detected by ultrasound, tumor size less than 4cm in 5 patients, diameter range from 4cm to 8cm in 36 cases, diameter larger than 8cm in 64 cases, in which 90 cases were biopsy by color Doppler ultrasound guided puncture, a total of 272 times puncture; 15 cases undergo cytology inspection by color Doppler ultrasound-guided puncture,a total of 17 times puncture.58 patients with intra-abdominal puncture, transvaginal puncture 47 patients, specimens selection satisfaction rate, diagnostic accuracy, sensitivity and specificity were 83.81%(88/105),80%(84/105),80.77%(84/104),100% (1/1)respectively. Including 1 case patients emerging a small amount of vaginal bleeding after transvaginal puncture, Vaginal gauze packing to stop bleeding, NES treatment.Conclusion:Ultrasound-guided puncture technique is accurate, reliable and safe, the key to success of puncture is to choose right puncture approach according to tumor location and size. Choose the posterior fornix vaginal biopsy, puncture approach is short, less trauma, less pain, safe and effective without the use of anesthetic during the puncture. The intra-abdominal pathway can be chosed if the nidus of lesions' location is high which cannot be punctured transvaginal. due to the diversity of ovarian tumors, ovarian tumors in shape, border, especially in terms of internal echo behave more complex than other tumors, resulting in less positive rate of ultrasound-guided biopsy than other organs. Objective:by comparing the two-dimensional color Doppler (CDFI) guided biopsy and contrast-enhanced ultrasound (CEUS) guided biopsy of ovarian neoplasms (OT) of the Success rate of the puncture, explore a method which can improve the biopsy positive rate of suspected ovarian cancer.Methods:86 patients with suspected ovarian cancer were confirmed by gynecological special inspection, and serum cancer antigen 125 (Ca125), intra-abdominal ultrasonography or transvaginal sonography, or other imaging inspection. All patients didn't have contraindications on biopsy and ultrasound contrast agent. In accordance with the principle of randomization all researching objects were divide into study group and control group by computer generated random numbers. Experimental group were inspected by contrast ultrasound using SonoVue, choose puncture target according to angiography; the control group were examed by conventional two-dimensional and color doppler ultrasound, choose puncture target according to the results of scanning, specimens selection satisfaction rate, diagnostic accuracy, sensitivity and specificity were compared, and the specimens selection satisfaction rate and diagnostic accuracy between the two group that have the same diameter and lesions of the same nature were compared.Results:1,The average puncture time of the experimental group was 2.59±0.948 (times/cases), less than the control group 3.02±0.917 (times/cases), difference between the two group has significance (P<0.05); the specimens selection satisfaction, diagnostic accuracy and among the experimental group was 97.56%(40/41),95.12% (39/41),95.12%(39/41)respectively,higher than that of the control group 82.22% (37/45),77.78%(35/45),77.78%(35/45), Differences are statistically significant (P<0.05).2,(1) The puncture results of nidus diameter larger than 8cm between experimental group and control group was:①specimens selection satisfaction and diagnostic accuracy of lesions have statistical significance (P<0.05)；②specimens selection satisfaction and the diagnostic accuracy of malignant lesions have statistical significance (P<0.05);③specimens selection satisfaction and diagnostic accuracy in benign lesion has no significance between the two groups(P>0.05). (2) The puncture results of nidus diameter range from 4cm to 8cm between experimental group and control group was:①the specimens selection satisfaction and diagnostic accuracy has no statistic meaning (P>0.05);②the specimens selection satisfaction and diagnostic accuracy in malignant lesions have statistical significance (P<0.05);③the specimens selection satisfaction and diagnostic accuracy in benign lesions also has no statistical significance (P>0.05). (3) lesions'diameter less than 4cm in the experimental group and control group were not suitable for statistical analysis because of less cases.Conclusion:1, Ultrasound guided needle biopsy on OT can greatly improve the diagnostic accuracy and sensitivity, while reduce the negative results in those nidus such as big and heterogeneous internal structure, two-dimensional and color doppler has difficult to display, and to some extent, improve the satisfaction rate of specimens selection satisfaction, reducing the time of puncture, thus reducing the postoperative complications and reduce the suffering of patients.2. The ultrasound imaging effects of puncture biopsy on different character and diameter OT lesions are different. In this study, for different diameter lesions, ultrasound imaging can improve the puncture biopsy specimens selection satisfaction and diagnostic accuracy in large lesions,for the medium sized and the big sized lesions the specimens selection satisfaction and diagnostic accuracy of biopsy have significantly increased, because of less cases of small to medium sized lesions,we can't get the conclusion that ultrasound imaging guided biopsy can improve the effectiveness of these small lesions, For the large lesions that has the same diameter, ultrasound imaging can improve the malignant lesions the specimens selection satisfaction and diagnostic accuracy of biopsy, but has no help in benign lesions.
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