Advertisement

Diagnostischer Einsatz bei Adnextumoren

  • G. Bogner
Chapter

Zusammenfassung

In diesem Kapitel wird der diagnostische Einsatz der Dopplersonographie bei Adnextumoren erläutert. Dazu werden zuerst die Grundlagen der Pathophysiologie, die Eigenschaften von Ovarialtumoren und mögliche Fehlerquellen beleuchtet. Daran schließt sich die Auswertung dopplersonographisch erhobener Daten im Zusammenhang mit Farbdoppler, Abhängigkeit von der Sonomorphologie sowie bezüglich der klinischen Anwendung und Analyse des Malignitätsrisikos an. Anhand von 3 Fallbeispielen wird der Einsatz praktisch dargestellt. Abschließend werden als weitere Adnexerkrankungen entzündliche Prozesse und die Ovaialtorsion erläutert.

Literatur

  1. Alcázar JL, Rodriguez D (2009) Three-dimensional power Doppler vascular sonographic sampling for predicting ovarian cancer in cystic-solid and solid vascularized masses. J Ultrasound Med 28(3):275–81CrossRefGoogle Scholar
  2. Alcázar, JL, Merce LT, Garcia Manero M (2005) Three-dimensional power Doppler vascular sampling: a new method for predicting ovarian cancer in vascularized complex adnexal masses. J Ultrasound Med. 24(5):689–96CrossRefGoogle Scholar
  3. Alcázar, J. L., Pascual, M. A., Graupera, B., Aubá, M., Errasti, T., Olartecoechea, B., Ruiz-Zambrana, A., Hereter, L., Ajossa, S. and Guerriero, S. (2016) External validation of IOTA simple descriptors and simple rules for classifying adnexal masses. Ultrasound Obstet Gynecol, 48: 397–402CrossRefGoogle Scholar
  4. Ameye L, Timmerman D, Valentin L, Paladini D, Zhang J, Van Holsbeke C, Lissoni AA, Savelli L, Veldman J, Testa AC, Amant F, Van Huffel S, Bourne T (2012) Clinically oriented three-step strategy for assessment of adnexal pathology. Ultrasound Obstet Gynecol 2012; 40: 582–591CrossRefGoogle Scholar
  5. Auslender R, Shen O, Kaufman Y, Goldberg Y, Bardicef M, Lissak A, Lavie O (2009) Doppler and gray-scale sonographic classification of adnexal torsion. Ultrasound Obstet Gynecol. 34(2):208–11CrossRefGoogle Scholar
  6. Bamberger ES, Perrett CW (2002) Angiogenesis in epithelian ovarian cancer. Molecular Pathology 2002;55(6):348–359.CrossRefGoogle Scholar
  7. Bogner G, Gruber R, Schaffer H, Staudach A (1996) Analyse farbdopplersonographischer Parameter zur Beurteilung der Dignität von Adnextumoren. Ultraschall Med 17 [Suppl]:17Google Scholar
  8. Bogner G, Gruber R, Steiner H, Schaffer H, Lundwall K, Staudach A (1996) Is the assessment of ovarian masses with colour doppler ultrasound dependent on training? Ultrasound Obstet Gynecol 8 [Suppl 1]:152Google Scholar
  9. Chen JJ, Chen JJ, Chiang CS, Hong JH, Yeh CK (2011) Assessment of tumor vasculature for diagnostic and therapeutic applications in a mouse model in vivo using 25-MHz power Doppler imaging. Ultrasonics. 2011 Dec;51(8):925–31.CrossRefGoogle Scholar
  10. Genç M, Solak A, Genç B, Sivrikoz ON, Kurtulmus S, Turan A, Sahin N, Gur EB (2015) A diagnostic dilemma for solid ovarian masses: the clinical and radiological aspects with differential diagnosis of 23 cases. Eur J Gynaecol Oncol. 2015;36(2):186–191PubMedGoogle Scholar
  11. Gruber R (1995) Bedeutung der Sonomorphologie und der farbcodierten Dopplersonographie in der Diagnostik von Adnextumoren. Dissertation, Leopold-Franzens-Universität InnsbruckGoogle Scholar
  12. Gruber R, Bogner G, Steiner H, Staudach A (1996) Reproduzierbarkeit farb-/dopplersonographischer Messungen im Rahmen der präoperativen Dignitätseinschätzung von Adnextumoren. Ultraschall Med 17 [Suppl]:17Google Scholar
  13. Guerriero S, Ajossa S, Garau N, Piras B, Paoletti AM, Melis GB (2005) Ultrasonography and color Doppler-based triage for adnexal masses to provide the most appropriate surgical approach. Am J Obstet Gynecol.; 192(2):401–6CrossRefGoogle Scholar
  14. Guerriero S, Alcazar JL, Coccia ME, Ajossa S, Scarselli G, Boi M, Gerada M, Melis GB (2002) Complex pelvic mass as a target of evaluation of vessel distribution by color Doppler sonography for the diagnosis of adnexal malignancies: results of a multicenter European study. J Ultrasound Med. 21(10):1105–11CrossRefGoogle Scholar
  15. Guerriero S, Ajossa S, Piras B, Gerada M, Floris S, Garau N, Minerba L, Paoletti AMm Melis GB (2007) Three-dimensional quantification of tumor vascularity as a tertiary test after B-mode and power Doppler evaluation for detection of ovarian cancer. J Ultrasound Med. 26(10):1271–8CrossRefGoogle Scholar
  16. Jacobs IJ, Menon U, Ryan A, et al. (2016) Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial. Lancet (London, England). 2016;387(10022):945–956CrossRefGoogle Scholar
  17. Jain RK et al. (2005) Normalization of Tumor Vasculature: An Emerging Concept in Antiangiogenic Therapy. Science, 07 Jan 2005:Vol. 307, Issue 5706, pp. 58–62CrossRefGoogle Scholar
  18. Kaijser, J., Bourne, T., Valentin, L., Sayasneh, A., Van Holsbeke, C., Vergote, I., Testa, A. C., Franchi, D., Van Calster, B. and Timmerman, D (2013) Improving strategies for diagnosing ovarian cancer: a summary of the International Ovarian Tumor Analysis (IOTA) studies. Ultrasound Obstet Gynecol, 41: 9–20CrossRefGoogle Scholar
  19. Kalmantis K, Rodolakis A, Daskalakis G, Antsaklis A (2013) Characterization of ovarian tumors and staging ovarian cancer with 3-dimensional power Doppler angiography: correlation with pathologic findings. Int J Gynecol Cancer. 2013 Mar;23(3):469–74CrossRefGoogle Scholar
  20. Liu Z, Yang F, Zhang Y, Yu H, Zhu H, Yang R, Fan L (2016) Conventional, Doppler and Contrast-Enhanced Ultrasonography in Differential Diagnosis of Ovarian Masses. Cell Physiol Biochem 2016;39:2398–2408CrossRefGoogle Scholar
  21. Mashiach R, Melamed N, Gilad N, Ben-Shitrit G, Meizner I (2011) Sonographic diagnosis of ovarian torsion: accuracy and predictive factors. J Ultrasound Med. 2011 Sep;30(9):1205–10CrossRefGoogle Scholar
  22. Meys EM, Kaijser J, Kruitwagen RF, Slangen BF, Van Calster B, Aertgeerts B, Verbakel JY, Timmerman D, Van Gorp T (2016) Subjective assessment versus ultrasound models to diagnose ovarian cancer: A systematic review and meta-analysis. Eur J Cancer. 2016 May;58:17–29CrossRefGoogle Scholar
  23. Molander P, Sjöberg J, Paavonen J, Cacciatore B. (2001) Transvaginal power Doppler findings in laparoscopically proven acute pelvic inflammatory disease. Ultrasound Obstet Gynecol. 17(3):233–8CrossRefGoogle Scholar
  24. Niemi RJ, Saarelainen SK, Luukkaala TH, Mäenpää JU. (2017) Reliability of preoperative evaluation of postmenopausal ovarian tumors. Journal of Ovarian Research. 2017;10:15CrossRefGoogle Scholar
  25. Nizar K, Deutsch M, Filmer S, Weizman B, Beloosesky R, Weiner Z (2009) Doppler studies of the ovarian venous blood flow in the diagnosis of adnexal torsion. J Clin Ultrasound 37(8):436–9CrossRefGoogle Scholar
  26. Roche O, Chavan N, Aquilina J, Rockall A (2012) Radiological appearances of gynaecological emergencies. Insights into Imaging. 2012;3(3):265–275CrossRefGoogle Scholar
  27. Romosan G, Valentin L (2014) The sensitivity and specificity of transvaginal ultrasound with regard to acute pelvic inflammatory disease: a review of the literature. Arch Gynecol Obstet. 2014 Apr;289(4):705–14CrossRefGoogle Scholar
  28. Schelling M, Braun M, Kuhn W, Bogner G, Gruber R, Gnirs J, Schneider KT, Ulm K, Rutke S, Staudach A (2000) Combined transvaginal B-mode and color Doppler sonography for differential diagnosis of ovarian tumors: results of a multivariate logistic regression analysis. Gynecol Oncol. 77(1):78–86CrossRefGoogle Scholar
  29. Silvestre L, Martins WP, Candido-dos-Reis FJ. (2015) Limitations of three-dimensional power Doppler angiography in preoperative evaluation of ovarian tumors. Journal of Ovarian Research. 2015;8:47CrossRefGoogle Scholar
  30. Sladkevicius P, Valentin L, Marsl K (1995) Transvaginal Doppler examination for the differential diagnosis of solid pelvic tumors. J Ultrasound Med 14:377–380CrossRefGoogle Scholar
  31. Sladkevicius, P. and Valentin, L (2013) Intra- and interobserver agreement when describing adnexal masses using the International Ovarian Tumor Analysis terms and definitions: a study on three-dimensional ultrasound volumes. Ultrasound Obstet Gynecol, 41: 318–327CrossRefGoogle Scholar
  32. Testa AC, Timmerman D, Van Belle V, Fruscella E, Van Holsbeke C, Savelli L, Ferrazzi E, Leone FP, Marret H, Tranquart F, Exacoustos C, Nazzaro G, Bokor D, Magri F, Van Huffel S, Ferrandina G, Valentin L (2009) Intravenous contrast ultrasound examination using contrast-tuned imaging (CnTI) and the contrast medium SonoVue for discrimination between benign and malignant adnexal masses with solid components. Ultrasound Obstet Gynecol. 34(6):699–710CrossRefGoogle Scholar
  33. Timmerman D, Ameye L, Fischerova D, Epstein E, Melis GB, Guerriero S, Van Holsbeke C, Savelli L, Fruscio R, Lissoni AA, Testa AC, Veldman J, Vergote I, Van Huffel S, Bourne T, Valentin L (2010) Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group. BMJ. 2010 Dec 14;341:c6839CrossRefGoogle Scholar
  34. Timmerman D, Van Calster B, Testa AC, Guerriero S, Fischerova D, Lissoni A, Van Holsbeke C, Fruscio R, Czekierdowski A, Jurkovic D, Savelli L, Vergote I, Bourne T, Van Huffel S, Valentin L (2010) Ovarian cancer prediction in adnexal masses using ultrasound-based logistic regression models: a temporal and external validation study by the IOTA group. Ultrasound in Obstetrics and Gynecology 35(2);226–234CrossRefGoogle Scholar
  35. Timmerman D. The use of mathematical models to evaluate pelvic masses; can they beat an expert operator? Best Pract Res Clin Obstet Gynaecol 2004; 18: 91–104CrossRefGoogle Scholar
  36. Valentin L, Ameye L, Franchi D, Guerriero S, Jurkovic D, Savelli L, Fischerova D, Lissoni A, Van Holsbeke C, Fruscio R, Van Huffel S, Testa A, Timmerman D (2013) Risk of malignancy in unilocular cysts: a study of 1148 adnexal masses classified as unilocular cysts at transvaginal ultrasound and review of the literature. Ultrasound Obstet Gynecol. 2013 Jan;41(1):80–9CrossRefGoogle Scholar
  37. Valentin L, Ameye L, Jurkovic D, Metzger U, Lécuru F, Van Huffel S, Timmerman D (2006) Which extrauterine pelvic masses are difficult to correctly classify as benign or malignant on the basis of ultrasound findings and is there a way of making a correct diagnosis? Ultrasound Obstet Gynecol. 27(4):438–44CrossRefGoogle Scholar
  38. Valentin L, Hagen B, Tingulstad S, Eik-Nes S (2001) Comparison of ’pattern recognition’ and logistic regression models for discrimination between benign and malignant pelvic masses: a prospective cross validation. Ultrasound Obstet Gynecol. Oct;18(4):357–65CrossRefGoogle Scholar
  39. Van Holsbeke C, Daemen A, Yazbek J, Holland TK, Bourne T, Mesens T, Lannoo L, De Moor B, De Jonge E, Testa AC, Valentin L, Jurkovic D, Timmerman D (2009) Ultrasound methods to distinguish between malignant and benign adnexal masses in the hands of examiners with different levels of experience. Ultrasound Obstet Gynecol. Oct;34(4):454–61CrossRefGoogle Scholar
  40. Vijayaraghavan SB (2004) Sonographic whirlpool sign in ovarian torsion. J Ultrasound Med. 2004 Dec;23(12):1643–9;CrossRefGoogle Scholar
  41. Yazbek J, Raju SK, Ben-Nagi J, Holland TK, Hillaby K, Jurkovic D (2008) Effect of quality of gynaecological ultrasonography on management of patients with suspected ovarian cancer: a randomised controlled trial. Lancet Oncol. 9(2):124–31CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Deutschland 2018

Authors and Affiliations

  • G. Bogner
    • 1
  1. 1.Universitätsklinik für Frauenheilkunde und Geburtshilfe der Paracelsus Medizinische UniversitätSalzburgÖsterreich

Personalised recommendations