Zusammenfassung
Die Diagnose „Ovarialkarzinom“ wird in 75% der Fälle erst im Stadium FIGO III/IV gestellt, und die 5-Jahres-Überlebensrate konnte trotz medizinischer Fortschritte nur mäßig auf 44% verbessert werden. Die Bildgebung erfolgt initial mittels transvaginalem Ultraschall (Sensitivität 90–96%, Spezifität 98–99% für ovarielle Läsionen). Benigne Befunde werden sonographisch im Verlauf kontrolliert oder laparoskopisch entfernt. Bei sonographisch unklaren Läsionen erlaubt die MRT in mehr als 90% eine definitive Diagnose. Sonographisch malignomsuspekte Läsionen sollten einem CT-Staging unterzogen werden. Diese Information ist entscheidend für die Therapiestratifizierung, die idealerweise in gynäkoonkologischen Zentren in multidisziplinärer Zusammenarbeit erfolgt. Bei peritonealer Karzinose werden Implantationen über 1 cm in der CT und MRT vergleichbar gut detektiert. Ein Aszites, der beim Ovarialkarzinom in bis zu 80% der Fälle mit einer peritonealen Karzinose assoziiert ist, lässt sich gleichermaßen mit Ultraschall, CT und MRT nachweisen.
Abstract
Ovarian cancer is diagnosed in stages FIGO III/IV in up to 75% of cases. Despite medical advances the 5-year survival rate has only been moderately increased to 44% during recent years. The initial evaluation is performed using transvaginal ultrasound (US) (sensitivity 90–96%, specificity 98–99% for detection of ovarian lesions). Probably benign findings will be followed-up sonographically or will be laparoscopically excised. Magnetic resonance imaging (MRI) allows a definitive diagnosis in more than 90% of sonographically indeterminate lesions. Malignant lesions require computer tomography (CT) staging and treatment in gynecooncology centers in a multidisciplinary setting. Peritoneal implants larger than 1 cm are detected equally by CT and MRI. Detection of ascites which is associated with peritoneal carcinomatosis in up to 80% of cases is equally feasible by US, CT and MRI.
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Danksagung
Dank gebührt Dr. Eva-Maria Arlt für die kritische Durchsicht des Manuskripts.
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Meissnitzer, M., Forstner, R. Radiologische Diagnostik des Ovarialkarzinoms. Radiologe 51, 581–588 (2011). https://doi.org/10.1007/s00117-010-2120-8
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DOI: https://doi.org/10.1007/s00117-010-2120-8