100 patients with ovarian cancer which were indicated of surgery at Tu Du Hospital from the year 2002 to 2004. The ultrasound scan results were compared with the anatonic pathology showed that ultrasound scan was a useful method in diagnosis and screening test for ovarian cancer. Especially the sensitivity and specificity of Doppler ultrasound were approximately 80%. Doppler ultrasound was the best method for diagnosis combination with the results of CA 125 in predicting the healthy and acute level of ovarian cancer
Ovarian Neoplasms ; diagnosis ; ultrasonography

All patients with ovarian tumors which were indicated for surgery at Tu Du Hospital were underwent ultrasound scan as a routine test. The ultrasound scan results were compared with the pathology results to evaluate the accuracy of ultrasound. There were 100 patients recruited for this study, in which 19 malignant tumors. According to Tokyo University classification, the sensitivity and specificity of ultrasound were 82.4% and 79%, respectively. According to the authors' classification, they were 82.8% and 88%. The sensitivity and specificity of Doppler ultrasound reached optimal value at RI < 0.5 and at PI < 1. Serious carcinoma and mucinous carcinoma had the highest prevalence (52.62%). Ultrasound could be used as a diagnostic and screening test for ovarian cancer
Ovarian Neoplasms ; diagnosis ; ultrasonography

OBJECTIVE: The aim was to assess the value of resistance index(RI) and pulsatility index(PI) to differentiate between benign and malignant ovarian tumors by color and pulsed Doppler ultrasound. METHODS: 129 ovarian tumors identified with ultrasound were referred for color and pulsed Doppler ultrasound evaluation to calculate the lowest RI and PI, and the corresponding histopathologic diagnosis was recorded. RESULTS: The intratumor artery waveforms were obtained in 37.1%(36 of 97) of benign tumors and in 91.0%(29 of 32) of the malignant group. RI and PI were lower in malignant tumors than in benign tumors(p<0.01). Also, there was a significant incremental decrease in both indices value from the benign tumor toward borderline malignancy(p<0.05) and to invasive ovarian cancer(p<0.01). But, there was no significant difference in both indices value according to the FIGO stage of ovarian malignancy. For RI cut-off value of 0.6, sensitivity and specificity were 89.7% and 91.7%; for PI cut-off value of 1.1, 86.2% and 91.7%. Therefore, the most accurate cut-off values of RI and PI were 0.6 and 1.1, respectively. CONCLUSION: RI and PI calculated by color and pulsed Doppler ultrasound can help in the diagnosis and selection of treatment plan of ovarian tumors, especially when the morphological finding of ovarian tumor is equivocal. And during the follow up of benign tumors, both indicies can give us the clue of malignant potential of benign tumors.
Arteries ; Diagnosis* ; Follow-Up Studies ; Ovarian Neoplasms* ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVE: The object of this study was to compare the diagnostic accuracy of a sonographic morphologic scoting system, the serum CA-125 assay, and a combination of both in patients undergoing laparotomy for a clinically diagnosed adnexal mass. METHODS: In 129 consecutive patients, the morphology of the mass was evaluated and scored by the morphologic scoring system of Sassones using transabdominal or transvaginal sonography and blood samples were obtained for CA-125 assay before planning surgery, RESULTS: The sensitivity of the sonographic morphologic scoring system was 90.6%, the specificity 84.5%, the positive predictive value 65.9%, and the negative predictive value 96.5%, compared with 68.8, 77.3, 50.0, and 88.2% for CA-125 and 96.9, 66.0, 48.4, and 98.5% for the two tests combined, respectively. Only one case of serous borderline ovarian tumor was missed when the two tests were combined. The sensitivity and mean value of the serum CA-125 increased with the stage of ovarian cancer. CONCLUSION: The combination of sonographic findings with a serum CA-125 assay was more sensitive, but less specific, than sonography or the serum CA-125 assay alone in predicting the malignancy of an adnexal mass. The serum CA-125 level generally reflected the stage of the disease. We think that it is reasonable to check the serum CA-125 only in cases of ovarian malignancy diagnosed by sonography.
Diagnosis* ; Humans ; Laparotomy ; Ovarian Neoplasms* ; Sensitivity and Specificity ; Ultrasonography*

We studied the best parameter to differentiate preoperatively between malignant ovarian tumors and benign ovarian tumors. From January 1988 to December 1992, 244 patients of ovarian tumor were treated with surgery at Chonnarn University Hospital. Patients diagnosed as malignancy by histopathology were 26.2%(64 patients), As the diagnostic pararnetar, we used age, ultrasonography, tumor markers, CT or MRI. The results were obtained as follows: 1. The predictive value of ultrasonographic examination for ovarian cancer was 73.1%. 2. The predictive value of seren CA-125 level for ovarian cancer was 69.1%. 3. The predictive value of combination af ultrasonographic examination and serum CA 125 level for ovarian cancer was 90%. 4. The predictive value of combination of the age older than 40 years, ultrasonographic examination and serum CA-125 level for warian canrer was 92.3%. 5. The predictive value of comhination of three tumor markers(CA-125, CEA and CA 72-4), ultrasonographic examination, CT and MRI for ovarian cancer was 94.6%. Finally, we could preaperatively most exactly differentiate between malignant ovarian tumors and benign ovarian tumors by use of age, three tumor markers(CA-125, CEA and CA 72-4) and ultrsonography, CT or MRI.
Diagnosis* ; Humans ; Magnetic Resonance Imaging ; Ovarian Neoplasms ; Biomarkers, Tumor ; Ultrasonography

PURPOSE: Ovarian epithelial tumors of borderline malignancy belong to a disease entity distnct from that ofbenign and overt malignant tumors, and the younger age of patients and earlier stage at diagnosis compared withinvasive ovarian cancers makes conservative surgery an important issue. The purpose of this study was to evaluatewhether there are any characteristic radiologic findings to suggest the presence of these tumors. MATERIALS AND METHODS: In 20 pathologically proven tumors of ovarian borderline malignancy, the findings of ultrasonography (n= 17) (with color Doppler ultrasonography in two cases), computed tomography (n = 8), or magnetic resonanceimaging (n = 6) were compared with pathologic findings and, were retrospectively reviewed and analyzed. Imageswere evaluated for size, loculation, thickness and regularity of wall and septum, endocystic vegetation, solidportion, calcification, local invasion and distant metastasis. RESULTS: Among 20 unilateral tumors, 18 weremucinous and two were serous; 19 (95%) were at stage I, and one was at stage II (local invasion of uterus, leftpara-aortic lymphadenopathy, and malignant ascites). Tumor size ranged from 10 - 40 cm in the largest diameter(mean, 21 cm). Radiologic findings of thick, irregular wall or septum were notified in 14 tumors (70%), endocysticvegetation in 12 (60%), enhancing solid portion in 11 (55%), and calcification in two (10%). Of 18 mucinoustumors, 17 (94%) were multilocular. One serous tumor was unilocular and one was multilocular. Color Dopplerultrasonography of two mucinous tumors revealed blood flow signals in the wall, septum, solid portion orendocystic vegetation, and resistive indices were 0.5 and 0.4, respectively. CONCLUSION: When ovarian tumors arepresent - especially in young females and at a lower stage -, radiologic findings of a thick, irregular wall orseptum, endocystic vegetation, and a small enhanced solid component, for example, indicate the possibility ofovarian epithelial tumors of borderline malignancy.
Diagnosis ; Female ; Humans ; Lymphatic Diseases ; Mucins ; Neoplasm Metastasis ; Ovarian Neoplasms ; Retrospective Studies ; Ultrasonography ; Ultrasonography, Doppler, Color ; Uterus

We present a case of a 40-yr-old woman diagnosed with a primary malignant struma ovarii. The patient was admitted with the complaint of pelvic pain and a large pelvic mass in the mid-portion of lower abdomen on gynecological examination. Pre-operative tumor markers and routine biochemistry were unremarkable. She was treated with total abdominal hysterectomy and right salpingo-oopherectomy. Post-operatively, she was diagnosed with a malignant struma ovarii through the usage of histopathological criteria similar to the guidelines for primary thyroid gland disease. The patient was subsequently performed left salpingo-oopherectomy and retroperitoneal pelvic lympadenectomy for re-staging. Although, left ovary and lymph nodes were histopathologically normal, she was offered thyroidectomy but she refused to accept the offer. Thyroglobulin level was monitored in the post-operative period. She is free of the disease for 18 months.
Adult ; Female ; Humans ; Hysterectomy ; Ovarian Neoplasms/*diagnosis/pathology/ultrasonography ; Ovariectomy ; Struma Ovarii/*diagnosis/pathology/secondary ; Thyroglobulin/metabolism

OBJECTIVE: Ovarian cancer is a silent disease with few symptoms. Because early detection of ovarian cancer is difficult, most cases are diagnosed at an advanced stage. To determine whether an ovarian tumor is malignant or not, various diagnostic procedures have been used including physical examination, ultrasound and tumor markers such as CA-125. We recently compared color Doppler sonography(CDS) with the morphological scoring system and CA-125 levels in establishing an accurate preoperative diagnosis of adnexal mass. As a result, we tried to compare the morphological scoring system with CA-125 and CDS in the diagnosis of adnexal mass. METHODS: The medical records of 47 patients referred with preexisting adnexal lesion were reviewed retrospectively by comparing ultrasonic data(morphological scoring system and color Doppler finding) with serum CA-125 and MRI findings. RESULTS: Forty-nine masses were removed surgically and confirmed as 25 malignancies and 22 benign tumors. In cases using the morphological scoring system and CA-125, the accuracy showed 95% sensitivity. In cases using the morphological scoring system and CDS, the sensitivity was 88%. In cases using the morphological scoring system and CDS, the sensitivity was 48%. CONCLUSIONS: The morphological scoring system and CA-125 are the basic methods for predicting ovarian malignancy. MRI and CDS may be also useful diagnosis methods in diagnosis of ovarian malignancy. But combination of these diagnositic modalities may not improve the accuracy of predicting ovarian malignancy, significantly.
Diagnosis ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Ovarian Neoplasms ; Physical Examination ; Retrospective Studies ; Biomarkers, Tumor ; Ultrasonics ; Ultrasonography*

OBJECTIVETo evaluate the ability of a risk of malignancy index (RMI), based on serum CA125 level, ultrasound findings and menopausal status, to discriminate benign from malignant pelvic mass.

METHODSOne hundred and forty women with pelvic masses, at age 30 of years or more were admitted to the Peking Union Medical College Hospital between January 1998 and June 1999. The sensitivity, specificity and positive predictive value of serum CA125 level, ultrasound findings and the menopausal status in diagnosis of ovarian cancer were evaluated separately or combined into the RMI.

RESULTSRMI was more accurate than any individual criterion in diagnosing cancer. Using an RMI cutoff level of 200 to indicate malignancy, the RMI derived from this data set gave a sensitivity of 87.3%, a specificity of 84.4%, and a positive predictive value of 82.1%.

CONCLUSIONSRMI is able to correctly discriminate malignant from benign pelvic mass. It can be introduced easily into clinical practice to facilitate the selection of patients for primary surgery.

CA-125 Antigen ; blood ; Female ; Humans ; Menopause ; Ovarian Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography

A mesothelial cyst of the round ligament is a rare cause of an inguinal mass. Clinically, it is frequently misdiagnosed as one of commoner diseases such as an inguinal hernia, femoral hernia, lipoma, and lymphadenopathy upon physical examination. Some previous reports elaborated the sonographic features of a mesothelial cyst of the round ligament. However, to our knowledge, few reports have described the CT features of a mesothelial cyst. We illustrated here the sonographic and multidetector CT features of a case of a mesothelial cyst of the round ligament that presented as an inguinal palpable mass and mimicked a metastasis in a patient with a Sertoli-Leydig cell tumor of the ovary.
Abdominal Neoplasms/*diagnosis/secondary ; Aged ; Contrast Media/diagnostic use ; Cysts/*radiography/*ultrasonography ; Diagnosis, Differential ; Epithelium/radiography/ultrasonography ; Female ; Humans ; Ovarian Neoplasms/*pathology ; Radiographic Image Enhancement/methods ; Round Ligament/*radiography/*ultrasonography ; Sertoli-Leydig Cell Tumor/*pathology ; Tomography, X-Ray Computed/methods