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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
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
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
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
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
Gonzalez CJ, Curson R, Parsons J (1988) Transabdominal versus transvaginal ultrasound scanning of ovarian follicles: are they comparable? Fertil Steril 50:657–659
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
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
Goldstein SR (1990) Incorporating endovaginal ultrasonography into the overall gynecologic examination.Am J Obstet Gynecol 162:625–632
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
Higgins RV,van Nagell JR, Woods CH et al. (1990) Interobserver variation in ovarian measurements using transvaginal sonography. Gynecol Oncol 39:69–71
Mendelson EB, Bohm-Velez M, Joseph N et al. (1988)Endometrial abnormalities: evaluation with transvaginal sonography.Am J Radiol 150:139–142
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
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
Crade M, Crade K (1995) Preliminary ovarian screening data from Long Beach Memorial Hospital.Personal communication
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
Granberg S, Norström A, Wikland M (1990) Tumors in the lower pelvis as imaged by transvaginal sonography. Gynecol Oncol 37:224–229
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
Timmerman D (1997) Ultrasonography in the assessment of ovarian and tamoxifen-associated endometrial pathology. Thesis, University of Leuven, Belgium (ISBN 906186 857 2)
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
Hermann UJ, Locher GW, Goldhirsch A (1987) Sonographic patterns of ovarian tumors: prediction of malignancy.Obstet Gynecol 69:777–781
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
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
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
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
Morley P, Barnett E (1970) The use of ultrasound in the diagnosis of pelvic masses. Br J Radiol 43:602–616
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
Gerber B, Muller H, Külz T et al. (1997) Simple ovarian cysts in premenopausal patients. Int J Gynaecol Obstet 57:49–55
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
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
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
Conway C, Zalud I, Dilena M et al. (1998) Simple cyst in the postmenopausal patient: detection and management. J Ultrasound Med 17:369–372
Kroon E, Andolf E (1995) Diagnosis and follow-up of simple ovarian cysts detected by ultrasound in postmenopausal women. Obstet Gynecol 85:211–214
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
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
Meire HB, Farrant P, Guha T (1978) Distinction of benign from malignant ovarian cysts by ultrasound. Br J Obstet Gynaecol 85:893–899
Sladkevicius P (1994) Doppler ultrasound studies in gynaecology. Thesis, Lund University, Malmö, Sweden
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
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
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
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
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
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
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
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
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
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
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
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
Rights 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