Skip to main content

The Use of Ultrasound to Assess the Morphology of Ovarian Tumours

  • Chapter
Ultrasound and Endoscopic Surgery in Obstetrics and Gynaecology
  • 281 Accesses

Abstract

The rapid development of ultrasound technology has led to an increase in the detection rate of ovarian cysts. Such cysts can be diagnosed at any age or stage of a woman’s life, from as early as the fetal stage to as late as the postmenopause. A high number of cystic structures are seen in the ovaries, even in postmenopausal women. Many of these regress spontaneously or remain unchanged. The clinical dilemma that these cystic structures cause for the clinician is well documented. Furthermore, it is also well known that transvaginal sonography plays an important role, not only in the detection of ovarian cysts, but also in the characterisation of these lesions. The problem for the clinician remains the same. Which cystic structures on the ovaries can be managed conservatively, and which need to be removed? Advances in surgery have now led to a further issue. If there is an ovarian cyst, is it suitable for minimal access surgery or are the services of a gynaecological oncologist required? This chapter will discuss some of the problems that appear at a clinical practice when using B-mode ultrasound and will also try to explain the significance of certain morphological features of ovarian tumours.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Wikland M, Enk L, Hamberger L et al. (1987) Use of a vaginal transducer for oocyte retrieval in an IVF/ET programme.J Clin Ultrasound 15:245–250

    Article  PubMed  CAS  Google Scholar 

  2. Quinn MJ, Beynon NJ, McC Mortenseon NJ et al.(1988) Transvaginal endosonography: a new method to study the anatomy of the lower urinary tract in urinary stress incontinence.Br J Urol 62:414–418

    Article  PubMed  CAS  Google Scholar 

  3. Timor-Tritsch IE, Farine D, Rosen MG (1989) A close look at early embryonic development with the high frequency vaginal transducer.Am J Obstet Gynecol 159:676–681

    Google Scholar 

  4. Khullar V, Salvatore S, Cardozo LC et al. (1994) A novel technique for measuring bladder wall thickness in women using transvaginal ultrasonography.Ultrasound Obstet Gynecol 4:220–223

    Article  PubMed  CAS  Google Scholar 

  5. Gonzalez CJ, Curson R, Parsons J (1988) Transabdominal versus transvaginal ultrasound scanning of ovarian follicles: are they comparable? Fertil Steril 50:657–659

    PubMed  CAS  Google Scholar 

  6. Bonilla-Musoles F, Pardo G, Perez-Gil M et al. (1989) Abdominal ultrasonography versus transvaginal scanning: accuracy in follicular development evaluation and prediction for oocyte retrieval in stimulated cycles.J Clin Ultrasound 17:469–473

    Article  PubMed  CAS  Google Scholar 

  7. Timor-Tritsch IE, Bar-Yam Y, Elgali S et al. (1988) The technique of transvaginal sonography with the use of the 6.5 MHz probe.Am J Obstet Gynecol 158:1019–1024

    PubMed  CAS  Google Scholar 

  8. Goldstein SR (1990) Incorporating endovaginal ultrasonography into the overall gynecologic examination.Am J Obstet Gynecol 162:625–632

    PubMed  CAS  Google Scholar 

  9. Rodriguez MH, Platt LD, Medearis AL et al. (1988) The use of transvaginal ultrasonography for evaluation of postmenopausal ovarian size and morphology.Am J Obstet Gynecol 159:810–814

    PubMed  CAS  Google Scholar 

  10. Higgins RV,van Nagell JR, Woods CH et al. (1990) Interobserver variation in ovarian measurements using transvaginal sonography. Gynecol Oncol 39:69–71

    Article  PubMed  CAS  Google Scholar 

  11. Mendelson EB, Bohm-Velez M, Joseph N et al. (1988)Endometrial abnormalities: evaluation with transvaginal sonography.Am J Radiol 150:139–142

    CAS  Google Scholar 

  12. Higgins RV,van Nagell Jr JR, Donaldson ES et al. (1989) Transvaginal sonography as a screening method for ovarian cancer.Gynecol Oncol 34:402–406

    Article  PubMed  CAS  Google Scholar 

  13. Van Nagell Jr JR, De Priest PD, Puls LE et al. (1991) Ovarian cancer screening in asymptomatic women by transvaginal ultrasonography. Cancer 68:458–462

    Article  PubMed  Google Scholar 

  14. Crade M, Crade K (1995) Preliminary ovarian screening data from Long Beach Memorial Hospital.Personal communication

    Google Scholar 

  15. Granberg S, Wikland M, Jansson I (1989) Macroscopic characterisation of ovarian tumors and the relation to the histological diagnosis: criteria to be used for ultrasound evaluation. Gynecol Oncol 35:139–144

    Article  PubMed  CAS  Google Scholar 

  16. Granberg S, Norström A, Wikland M (1990) Tumors in the lower pelvis as imaged by transvaginal sonography. Gynecol Oncol 37:224–229

    Article  PubMed  CAS  Google Scholar 

  17. Sassone AM, Timor-Tritsch IE, Artner A et al. (1991) Transvaginal sonographic characterisation of ovarian disease: evaluation of a new scoring system to predict ovarian malignancy.Obstet Gynecol 78:70–76

    PubMed  CAS  Google Scholar 

  18. Timmerman D (1997) Ultrasonography in the assessment of ovarian and tamoxifen-associated endometrial pathology. Thesis, University of Leuven, Belgium (ISBN 906186 857 2)

    Google Scholar 

  19. Bourne TH, Campbell S, Reynolds K et al (1993) Screening for early familial ovarian cancer with transvaginal ultrasonography and colour blood flow imaging.Br Med J 306: 1025–1029

    Article  CAS  Google Scholar 

  20. Hermann UJ, Locher GW, Goldhirsch A (1987) Sonographic patterns of ovarian tumors: prediction of malignancy.Obstet Gynecol 69:777–781

    Google Scholar 

  21. DeLand M, Fried A,van Nagell JR et al. (1979) Ultrasonography in the diagnosis of tumors of the ovary. Surg Gynecol Obstet 148:346–348

    PubMed  CAS  Google Scholar 

  22. Champault G, Cazacu F, Taffiner N (1996) Serious trocar accidents in laparoscopic surgery - a French survey of 103 852 operations. Surg Lap Endosc 6:367–370

    Article  CAS  Google Scholar 

  23. Goldstein S, Subramanyam B, Snyder J et al. (1988) The postmenopausal cystic adnexal mass: the potential role of ultrasound in conservative management. Obstet Gynecol 73:8–10

    Google Scholar 

  24. Valentin L, Sladkevicius P, Marsal K (1994) Limited contribution of Doppler velocimetry to the differential diagnosis of extrauterine pelvic tumors. Obstet Gynecol 83:425–433

    PubMed  CAS  Google Scholar 

  25. Morley P, Barnett E (1970) The use of ultrasound in the diagnosis of pelvic masses. Br J Radiol 43:602–616

    Article  PubMed  CAS  Google Scholar 

  26. De Priest P, Gallion H, Pavlik E et al. (1997) Transvaginal sonography as a screening method for the detection of early ovarian cancer. Gynecol Oncol 65:408–414

    Article  Google Scholar 

  27. Gerber B, Muller H, Külz T et al. (1997) Simple ovarian cysts in premenopausal patients. Int J Gynaecol Obstet 57:49–55

    Article  PubMed  CAS  Google Scholar 

  28. Bailey C, Ueland F, DePriest P et al. (1998) The malignant potential of small cystic ovarian tumors in women over 50 years of age. Gynecol Oncol 69:3–7

    Article  PubMed  CAS  Google Scholar 

  29. Obwegeser R, Deutinger J, Bernascheck G (1993) The risk of malignancy with an apparently simple adnexal cyst on ultrasound. Arch Gynecol Obstet 253:117–120

    Article  PubMed  CAS  Google Scholar 

  30. Auslender R, Atlas I, Lissak A et al. (1996) Follow-up of small postmenopausal ovarian cysts using vaginal ultrasound and CA-125 antigen. J Clin Ultrasound 24:175–178

    Article  PubMed  CAS  Google Scholar 

  31. Conway C, Zalud I, Dilena M et al. (1998) Simple cyst in the postmenopausal patient: detection and management. J Ultrasound Med 17:369–372

    PubMed  CAS  Google Scholar 

  32. Kroon E, Andolf E (1995) Diagnosis and follow-up of simple ovarian cysts detected by ultrasound in postmenopausal women. Obstet Gynecol 85:211–214

    Article  PubMed  CAS  Google Scholar 

  33. Osmers R, Osmers M,von Maydell B et al. (1998) Evaluation of ovarian tumors in postmenopausal women by transvaginal sonography. Eur J Obstet Gynecol 77:81–88

    Article  CAS  Google Scholar 

  34. Ekerhovd E, Wienerroith H, Staudach A et al. (2001) Preoperative assessment of unilocular adnexal cysts by transvaginal sonography: a comparison between sonographic morphological imaging and histolopathologic diagnosis. Am J Obstet Gynecol 184:48–54

    Article  PubMed  CAS  Google Scholar 

  35. Meire HB, Farrant P, Guha T (1978) Distinction of benign from malignant ovarian cysts by ultrasound. Br J Obstet Gynaecol 85:893–899

    Article  PubMed  CAS  Google Scholar 

  36. Sladkevicius P (1994) Doppler ultrasound studies in gynaecology. Thesis, Lund University, Malmö, Sweden

    Google Scholar 

  37. Bourne T (1995) Screening for early familial ovarian cancer and the diagnosis of endometrial and ovarian pathology using transvaginal ultrasonography with and without color Doppler. Thesis, University of Göteborg, Sweden

    Google Scholar 

  38. Timor-Tritsch LE, Lerner JP, Monteagudo A et al. (1993) Transvaginal ultrasonographic characterization of ovarian masses by means of color flow-directed Doppler measurements and a morphologic scoring system. Am J Obstet Gynecol 168:909–913

    PubMed  CAS  Google Scholar 

  39. Timmerman D, Bourne TH, Tailor A et al. (1999) A comparison of methods for the pre-operative discrimination between benign and malignant adnexal masses: the development of a new logistic regression model. Am J Obstet Gynecol 181:57–65

    Article  PubMed  CAS  Google Scholar 

  40. Lerner JP, Timor-Tritsch IE, Federman A et al. (1994) Transvaginal ultrasonographic characterisation of ovarian masses with an improved, weighted scoring system. Am J Obstet Gynecol 170:81–85

    PubMed  CAS  Google Scholar 

  41. Finkler NJ, Benacerraf B, Lavin PT et al. (1988) Comparison of serum CA 125, clinical impression, and ultrasound in the preoperative evaluation of ovarian masses. Obstet Gynecol 72:659–664

    PubMed  CAS  Google Scholar 

  42. Hata K, Hata H, Manabe A et al. (1992) A critical evaluation of transvaginal Doppler studies, transvaginal ultrasonography, magnetic resonance imaging, and CA 125 in detecting ovarian cancer. Obstet Gynecol 80:922–926

    PubMed  CAS  Google Scholar 

  43. Ferrazzi E, Zanetta G, Dordoni D et al. (1997) Transvaginal ultrasonographic characterization of ovarian masses: comparison of five scoring systems in a multicenter study. Ultrasound Obstet Gynecol 10:192–197

    Article  PubMed  CAS  Google Scholar 

  44. Jacobs I, Oram D, Fairbanks J et al. (1990) A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br J Obstet Gynaecol 97:922–929

    Article  PubMed  CAS  Google Scholar 

  45. Tailor A, Jurkovic D, Bourne T et al. (1997) Sonographic prediction of malignancy in adnexal masses using multivariate logistic regression analysis. Ultrasound Obstet Gynecol 10:41–47

    Article  PubMed  CAS  Google Scholar 

  46. Timmerman D, Verreist H, Bourne T et al. (1999) Artificial neural network models for the pre-operative discrimination between malignant and benign adnexal masses. Ultrasound Obstet Gynaecol 13:17–25

    Article  CAS  Google Scholar 

  47. Timmerman D, Schwärzler P, Collins WP et al. (1999) Subjective assessment of adnexal masses using ultrasonography: an analysis of interobserver variability and experience. Ultrasound Obstet Gynecol 13:11–16

    Article  PubMed  CAS  Google Scholar 

  48. Vergote I, De Bralanter J, Fyles A et al. (2001) Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian cancinoma. Lancet 357: 176–182

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer-Verlag London Limited

About this chapter

Cite this chapter

Granberg, S., Ekerhovd, E., Timmerman, D., Bourne, T. (2003). The Use of Ultrasound to Assess the Morphology of Ovarian Tumours. In: Ultrasound and Endoscopic Surgery in Obstetrics and Gynaecology. Springer, London. https://doi.org/10.1007/978-1-4471-0655-5_21

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-0655-5_21

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1170-2

  • Online ISBN: 978-1-4471-0655-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics