How to detect ovarian tumor

The so-called color Doppler ultrasound (CDFI), referred to as color ultrasound, is actually the product of the combination of high-definition black and white B-ultrasound and color Doppler. Because color ultrasound has the advantages of two-dimensional ultrasound structural images and provides rich information on hemodynamics, its clinical application is becoming more and more extensive.

In recent years, CDFI examination technology is often used to distinguish benign and malignant ovarian tumors.

The incidence of ovarian cancer is increasing year by year, and it is difficult to detect the disease in its early stages. In view of this, domestic and foreign scholars recommend regular B-ultrasound screening for high-risk groups, who are 50% more likely to develop ovarian cancer than the general population. If the ovarian volume of menopausal women is ≥8cm3 by ultrasound examination, or the ovarian volume of women of childbearing age is ≥18cm3, the possibility of malignant ovarian tumors should be highly suspected. This will provide more abundant information for gynecological clinical diagnosis. It will be of great help in early detection of malignant ovarian tumors and reducing mortality.

Weber and other foreign researchers proposed to predict benign and malignant tumors based on 10 sonographic indicators:

① Tumor structure; ② Tumor boundary; ③ Wall thickness; ④ Echo in the cystic part; ⑤ Septum; ⑥ Morphology of chaotic echo or solid tumor; ⑦ Echo distribution of chaotic echo or solid tumor; ⑧ Acoustic attenuation behind the tumor; ⑨ Ascites; ⑩ Liver metastasis.

Each indicator is calculated from 0 to 2 points. The research results show that a score ≥ 10 points is used as the standard for diagnosing malignant tumors, with a sensitivity of 96.8, a specificity of 91.2, a positive predictive value of 91.2, and a negative predictive value of 96.9.

In fact, CDFI can not only show the distribution of blood vessels inside and around the tumor, but also analyze hemodynamic parameters, which helps to distinguish benign from malignant tumors. The venous system of a normal ovary is roughly parallel to the arterial system and is distributed in a vine-like manner. However, the angiogenesis of ovarian tumors is irregular and is closely related to the growth of the tumor and its metastasis to the surrounding areas. Studies have confirmed that tumor angiogenesis plays an important role in the formation, growth and metastasis of tumors.

CDFI examination of blood vessels in ovarian malignant tumors has the following characteristics:

① Irregular course, lack of gradual tapering process; ② Increased permeability, blood flow stasis; ③ Relative to the size of the vessel diameter, the content of vascular smooth muscle in malignant tumors is reduced; ④ There are many arteriovenous shunt anastomoses; ⑤ Low blood flow resistance.

Some researchers in China believe that diffuse blood flow distribution in the tumor and tumor blood vessels penetrating the nipple are the main features of CDE diagnosis of ovarian cancer. Malignant tumors have the spectrum characteristics of high flow velocity and low resistance, which provides a basis for Doppler ultrasound to distinguish benign and malignant ovarian tumors based on the blood flow spectrum morphology.

The CDFI examination can be used to preliminarily determine the nature of ovarian tumors. However, in order to confirm the benign or malignant nature of ovarian tumors, a comprehensive analysis and judgment of multiple test results such as serum tumor marker determination, immunohistochemistry analysis, and genetic testing is required to finally confirm the nature of the ovarian tumor.