초음파 단층상을 이용한 골반종양의 진단적 가치 = Diagnostic Value of Ultrasonography in Gynecological Tumors

다국어 초록 (Multilingual Abstract)

Although the clinical use of diagnostic ultrasound is well established, it`s value in gynecology is yet controversal. Authors experienced the 175 consecutive gynecologic patients, under the diagnosis of pelvic tumors including 45 cases of myoma uteri, 87 cases of adnexal masses, 30 cases of hydatidiform mole, 9 cases of malignant pelvic masses and 4 cases of pelvic inflammatory diseases with masses, clinically. They were assessed to the value of the ultrasonogram as the diagnostic procedure; they are divided from 3 group that diagnostic pictures with only ultrasound, adjunctive pictures in coincidence with clinical impression and the group with missed sonographic diagnosis. Final diagnosis was confirmed by operative findings and/or repeated sonographic picture and pathologic results in the clinical courses. Ultrasonogram was of great diagnostic value in myoma uteri and benign ovarian cysts among the pelvic tumors. The full bladder technic is used as an index of the differential diagnosis of solid and cystic masses. 1) As the energy volume is amplified (regulating by total gain, near gain and STC set in our apparatus), fluid filled structure remain relatively echo­free while solid structure is filled up with multiple echoes. 2) Especially, soild mass such as myoma uteri is poorly penetrated with ultrasound and with only increased STC(-3), the posterior wall of uterus is clearly defined. Otherwise, cystic mass such as ovarian cyst is well demarcated with linear echoes in lower grade of energy volume. 3) In myoma uteri with pregnancy, the power of penetration in ultrasound is more attenuated than solid mass. 4) The malignant pelvic masses are not characteristic in the sonographic pictures recently. The results are as follows: 1. Diagnostic ultrasonogrphic pictures are drawed in 32cases of the 175(18.2%). That is, 7cases of 39 in myoma uteri and 10 of the 78 cases in ovarian cysts, 11 of the 30 cases in hydatidiform mole, 4 cases of pelvic inflammatory diseases with mass are confirmed by only ultrasonogram. 2. Adjunctive information including accurate size of mass, secondary change of tumor are obtained in the 32 of myoma uteri, 68 of ovarian cysts and 19 cases of hydatidiform mole. (69.5%) 3. In 24cases among the 175, the ultrasonographic diagnosis are inaccurate. (12.3%). Most of malignant pelvic tumor are not diagnostic at present. Generally, the interpretation of sonographic picture is based upon the above characteristic findings.