The Ultrasound Diagnosis In Ovarian Mature Cystic Teratoma

Objective To analyze the ultrasonographic features of the ovarian mature cystic teratomas (MCT) and investigate the causes of the misdiagnosis and undetermined diagnosis to improve the accuracy of ultrasonography.Materials and Methods Ultrasonographic images of54pathologically confirmed ovarian MCT in50patients were retrospectively analyzed. The patients aged from20to60years old with the average years of34.8. Ultrasonographic examination was performed using the ultrasound diagnostic apparatus of GE LOGIQ7, LOGIQ400and Philips IU22. Four patients underwent abdominal ultrasonography,43cases underwent transvaginal ultrasonography, and the remaining3cases underwent combined examination of abdominal and transvaginal ultrasonography. Tumor location, shape, size, boundary, internal echo, cystic wall, septum thickness and rear shadow were analyzed on two-dimensional ultrasonographic images. Dynamic parameters were obtained using color Doppler flow imaging (CDFI). The accuracy of preoperative ultrasonography was evaluated and the causes of the misdiagnosis undetermined diagnosis were summarized by compared with pathologic resultsResults Of54tumors, the preoperative ultrasonography determinate accurately43thmors of40cases, with accuracy of79.6%. They appeared as three types:cystic in10tumors, solid in7tumors and mixed in26tumors. The diagnosis accuracy for each type was66.7%,87.5%and89.7%, respectively, Hair and fat echo could be identified in all these tumors. Eleven tumors in10patients were diagnosed inaccurately on preoperative ultrasonography with the missed diagnosis in2tumor (3.7%), misdiagnosis in2tumors (3.7%), undetermined in5tumors (9.3%), undetermined origin and undetermined diagnosis and origin in one tumor (1.9%), respectively. Hair and fat echo could not be identified definitively in these cases. The reasons of inaccurate diagnosis related to improper gain regulation, overlooked fine structure and fat liquefaction which confused the display of hair and fat.Conclusion Ultrasonography is a useful imaging tool for the diagnosis of typical ovarian MCT. However, the imaging features of atypical ovarian MCT may mimic other pelvic lesions. The multiple views in various positions with association with the menstrual history may improve the identification of fine structures to reduce the misdiagnosis and missed diagnosis.