OBJECTIVETo summarize the ultrasonographic characteristics of ovarian carcinosarcoma (OCS).

METHODSTotally 12 patients with OCS have been detected in our department. All patients underwent surgical resection and the OCSs were confirmed pathologically. Ultrasound examination was performed before operation. Imaging features were analyzed retrospectively for bilaterality, size, and tumor solidity (cystic or solid). Presence of ascites and other evidence of peritoneal seeding, adjacent organ invasion, and surgical staging were also evaluated.

RESULTSUnilateral OCSs were found in 11 patients and bilateral OCSs in one patient one side was missed by ultrasound). Nine OCSs were solid, and 3 were mixed (solid and cystic). The diameter of the largest dimension was less than 10 cm in 4 cases, 10-20 cm in 7 cases, and larger than 20 cm in one case. Other ultrasonographic findings including peritoneal seeding and direct invasion into the adjacent organs were seen in 8 patients. Surgical stages were International Federation of Gynecology and Obstetrics (FIGO) classification c and b in one patient each, c in 9 patients, and in one patient.

CONCLUSIONOCSs usually present as large, hypoechoic, solid, and aggressive tumors, combined with frequent peritoneal seeding and adjacent organ invasion.

Adult ; Aged ; Carcinosarcoma ; diagnostic imaging ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; diagnostic imaging ; Retrospective Studies ; Ultrasonography

OBJECTIVETo evaluate the surgery in simple ovarian cysts.

METHODSFrom Jan. 1994 to Dec. 1999, 221 women with simple ovarian cysts were admitted into our hospital. The diameter of cysts was < 5 cm in 76 cases, and was > or = 5 cm in 145 cases ultrasonically. One hundred and eighty-four patients underwent laparoscopy, and thirty-seven underwent laparotomy.

RESULTSHistological findings showed no malignancy in this series. Simple cysts, paraovarian cysts and corpus luteum were found histologically in 90.8% of cases with cysts < 5 cm, and 60% of those with cysts > 7 cm respectively, their difference was significant (chi2=37.13, P<0.001). The simple cysts, paraovarian cysts and corpus luteum cysts were found in 81.5% of postmenopausal women and 84.0% of premenopausal women.

CONCLUSIONPatients with cysts > 7 cm are indicated for surgical procedures, while a period of followup is acceptable for patients with cysts < 7 cm, and surgery is advisable if the cyst is persistent during followup. Postmenopausal women with cysts should have operations.

Endometriosis ; diagnostic imaging ; surgery ; Evaluation Studies as Topic ; Female ; Humans ; Laparoscopy ; Laparotomy ; Ovarian Cysts ; diagnostic imaging ; pathology ; surgery ; Ovarian Diseases ; diagnostic imaging ; surgery ; Ovarian Neoplasms ; diagnostic imaging ; surgery ; Teratoma ; diagnostic imaging ; surgery ; Ultrasonography

Adolescent ; Adult ; Child ; Diagnostic Errors ; Female ; Humans ; Male ; Middle Aged ; Ovarian Neoplasms ; diagnostic imaging ; Teratoma ; diagnostic imaging ; Ultrasonography

Ovarian cancer is one of the three most common gynecological cancers in the world, and is regarded as a priority in terms of women's cancer. In the past few years, many researchers have attempted to develop and apply artificial intelligence (AI) techniques to multiple clinical scenarios of ovarian cancer, especially in the field of medical imaging. AI-assisted imaging studies have involved computer tomography (CT), ultrasonography (US), and magnetic resonance imaging (MRI). In this review, we perform a literature search on the published studies that using AI techniques in the medical care of ovarian cancer, and bring up the advances in terms of four clinical aspects, including medical diagnosis, pathological classification, targeted biopsy guidance, and prognosis prediction. Meanwhile, current status and existing issues of the researches on AI application in ovarian cancer are discussed.
Artificial Intelligence ; Female ; Humans ; Magnetic Resonance Imaging ; Ovarian Neoplasms/diagnostic imaging* ; Prognosis ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the ability of multidetector computed tomography (MDCT) in differentiating ovarian tumors from non-ovarian masses.

METHODSForty-two cases with pelvic masses were examined with 16-row MDCT. All source image of each case was put into workstation for multi-planar reconstruction (MPR) and curved planar reconstruction(CPR). Axial image combined with 2D image was used for determining the relationship of the mass to ovarian vascular pedicle and identifying the normal ovary, which was compared with postoperative pathologic result and the finding during operation. All the data was compared using Fisher's exact test.

RESULTSThere were 28 ovarian tumors and 14 non-ovarian tumors in this series. If the ovarian vascular pedicle sign was used for determining whether the tumor was from the ovary or not, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 89.3%, 85.7%, 92.6%, 80.0% and 88.1%, respectively, with a significant difference in differentiating the tumor from the ovary or non-ovarian organs (P <0.05). If the identification of full normal ovary was used to determine non-ovarian origin of the tumor, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 50.0%, 100.0%, 100.0%, 80.0% and 83.3%, respectively, also with a significant difference in differentiating the tumors from the ovary or non-ovarian organs (P <0.05).

CONCLUSIONMDCT can clearly show the relationship of the tumor to the normal ovary and its vascular pedicle, which is very helpful in differentiating the ovarian tumors from a non-ovarian masses.

Adult ; Aged ; Cystadenocarcinoma, Mucinous ; diagnostic imaging ; Cystadenocarcinoma, Serous ; diagnostic imaging ; Cystadenoma, Mucinous ; diagnostic imaging ; Cystadenoma, Serous ; diagnostic imaging ; Diagnosis, Differential ; Female ; Gastrointestinal Stromal Tumors ; diagnostic imaging ; Humans ; Leiomyoma ; diagnostic imaging ; Middle Aged ; Ovarian Neoplasms ; diagnostic imaging ; Ovary ; blood supply ; diagnostic imaging ; Retroperitoneal Neoplasms ; diagnostic imaging ; Teratoma ; diagnostic imaging ; Tomography, X-Ray Computed ; methods ; Uterine Neoplasms ; diagnostic imaging ; Young Adult

OBJECTIVETo investigate the sonographic features of struma ovarii and its corresponding histopathologic findings.

METHODSThe sonographic and histopathological features of 72 patients with histopathologically comfirmed struma ovarii who were treated in Peking Union Medical College Hospital from January 2005 to December 2014 were retrospectively reviewed.

RESULTSOf these 72 patients,71 had benign struma ovarii(73 lesions)and one patient had malignant struma ovarii(1 lesion). On ultrasonography,all the 73 benign lesions had distinct margin,45(61.6%)had multilocular cystic or cystic-solid mass,49(67.1%)had irregular shape,and 28(38.4%)had nodular solid protrusions in the cystic areas. On the color Doppler flow imaging,36(49.3%)lesions had blood flow signals. The ultrasonographic features of the malignant struma ovarii lesion were multilocular cystic-solid mass with several nodular solid protrusions in the cysic areas;on the color Doppler flow imaging,blood flow signals were visible within septa and solid areas.

CONCLUSIONSThe sonographic features of struma ovarii are diverse. If ultrasonography reveals multilocular cystic or cystic-solid mass with distinct margin and isoechoic or hyperechoic nodular solid protrusions in the cystic areas with visible blood flow signals,the diagnosis of struma ovarii should be considered.

Humans ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Retrospective Studies ; Struma Ovarii ; diagnostic imaging ; pathology ; Ultrasonography

OBJECTIVETo study the value of multislice spiral computed tomography (CT) in the diagnosis of ovarian fibroma.

METHODThe CT findings of 9 cases with pathologically confirmed ovarian fibroma were retrospectively analyzed by two radiologists.

RESULTSAll of the 9 cases showed unilateral adnexal mass with demarcated boundary. There were three different types of ovarian fibroma according to the CT appearances simple type(n=4), degeneration type(n=3) and the ovarian fibroma with ascites(n=2). The simple type showed homogeneous-density solid tumor with no enhancement; two of them diagnosed as uterine leiomyomas and the other two as benign tumor originated from the ovary. The degeneration type showed irregular or round hypodensity inside the tumor with no enhancement; one of them was diagnosed as malignant tumor and the other two as intrapelvic mass. The ovarian fibroma with ascites showed homogeneous density with no enhancement; one with ascites and pelvic effusion and the other one with pleural effusion, ascites and pelvic effusion, both of whom were diagnosed as malignant tumor that possibly originated from the ovary.

CONCLUSIONSThe ovarian fibroma has diverse CT findings. They often appear as a unilateral adnexal solid tumor without obvious enhancement. A diagnosis of Meigs's syndrome may be made when it is accompanied with ascites and pleural effusion.

Adult ; Aged ; Female ; Fibroma ; diagnostic imaging ; Humans ; Middle Aged ; Ovarian Neoplasms ; diagnostic imaging ; Retrospective Studies ; Tomography, X-Ray Computed ; methods

OBJECTIVETo analyze the correlation between the perfusion data and microvessel density (MVD) in ovarian tumors, and investigate the hemodynamic features of the tumors in terms of anatomy and functional CT imaging.

METHODSSix patients with surgically confirmed benign ovarian tumors and 6 with malignant ovarian tumors underwent multi-slice CT perfusion imaging to acquire the perfusion parameters including perfusion, PEI, TTP, BV peak enhancement image(PEI), time to peak(TTP) and blood volume(BV). The tumors were stained and counted by Immunohistochemical staining of the microvessels in the tumor was performed to detect the MVD.

RESULTSs The time-density curves of the benign ovarian tumors increased slowly, reaching the peak at 40 s; the curves of the malignant tumors rose rapidly and continuously and reached the peak at 25 s. The differences in the perfusion data (PEI, TTP, BV) were statistically significant between the benign and malignant tumors (P<0.05). The MVD of the malignant tumors was significantly greater than that of the benign tumors (P<0.05). The mean BV of the malignant ovarian tumor was positively correlated to MVD (r=0.786, P<0.05).

CONCLUSIONMulti-slice spiral CT perfusion imaging can provide accurate enhancement data of the ovarian tumors and helps in the diagnosis and differential diagnosis of the ovarian tumors by presenting the changes of the hemodynamic features in the tumors.

Adult ; Aged ; Capillaries ; pathology ; Cystadenocarcinoma ; blood supply ; diagnostic imaging ; Female ; Fibroma ; blood supply ; diagnostic imaging ; Humans ; Middle Aged ; Ovarian Neoplasms ; blood supply ; diagnostic imaging ; Tomography, Spiral Computed ; methods

OBJECTIVES: International Ovarian Tumor Analysis (IOTA) working group proposed a logistic regression (IOTA LR2) model. It is served as a risk prediction model for benign and malignant adnexal tumors. This study aims to compare the diagnostic efficiency between the IOTA LR2 model and doctors' subjective assessment on diagnosing benign and malignant adnexal mass. METHODS: The ultrasonographic images of 616 adnexal masses were retrospectively analyzed by the senior doctors' group and the junior doctors' group using the IOTA LR2 model and subjective assessment. The postoperative pathological diagnosis was used as the gold standard to compare the diagnostic efficiency of the 2 methods. RESULTS: The area under the curves of subjective assessment and IOTA LR2 model for diagnosing malignant adnexal masses were 0.86 and 0.90 for the senior doctors' group and 0.79 and 0.88 for the junior doctors' group, respectively. The sensitivity and specificity of subjective assessment for diagnosing the malignant adnexal masses were 81.0% and 91.3% for the senior doctors' group and 70.1% and 88.7% for the junior doctors' group, respectively. The sensitivity and specificity of the IOTA LR2 model for diagnosing the malignant adnexal masses were 79.6% and 88.1% for the senior doctors' group, and 79.6% and 81.7% for the junior doctors' group, respectively.There were no significant difference in the sensitivities between the senior doctors' group and junior doctors' group using the IOTA LR2 model and the senior doctors' group using subjective assessment (both P>0.05). CONCLUSIONS The diagnostic efficiency of the IOTA LR2 model is equal to the senior doctors' experiences. This model can help junior doctors to reduce the missed diagnosis of malignant adnexal masses.
Adnexal Diseases/pathology* ; Diagnosis, Differential ; Female ; Humans ; Ovarian Neoplasms/diagnostic imaging* ; Retrospective Studies

Uterine tumors resembling ovarian sex cord tumors are rarely reported with limited imaging findings.The current study reported two case of uterine tumors resembling ovarian sex cord tumors and described the detailed MRI findings,which would provide valuable imaging evidence for the diagnosis of such tumors.
Female ; Humans ; Uterine Neoplasms/diagnostic imaging* ; Ovarian Neoplasms/pathology* ; Sex Cord-Gonadal Stromal Tumors/pathology* ; Magnetic Resonance Imaging