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@#<b>Objective</b> To evaluate the clinical significance of transvaginal color Doppler ultrasound for the differential diagnosis of benign and malignant ovarian cysts. <b>Methods</b> Patients who were diagnosed with clinically suspected or palpable adnexal masses and underwent gray-scale ultrasonography, transvaginal color Doppler ultrasonography, and ultrasound-guided fine-needle aspiration cytology (FNAC) during the period from 2018 to 2021 were enrolled in this study. The pulsatility index (<i>PI</i>) and resistance index (<i>RI</i>) were estimated, and an ovarian cyst with the lowest <i>PI</i> value of < 1.0 or the lowest <i>RI</i> value of < 0.4 was considered as malignant. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of gray-scale ultrasound and transvaginal color Doppler ultrasound for the differential diagnosis of benign and malignant ovarian cysts were estimated with FNAC as the gold standard. <b>Results</b> A total of 180 patients with ovarian cysts were recruited, and FNAC revealed that 81 of them had malignant lesions and 99 of them had benign lesions. The transvaginal color Doppler ultrasonograms showed that 75 patients (92.59%) with malignant lesions had blood-flow signals in their cysts and 42 patients (42.24%) with benign lesions had blood-flow signals in their cysts, with a significant difference in the proportion between the two groups (<i>χ</i><sup>2</sup> = 49.29, <i>P</i> < 0.01). Among the 75 patients with blood-flow signals in malignant ovarian cysts, 75 had <i>PI</i> < 1.0 and 24 had <i>RI</i> < 0.4; among the 42 patients with blood-flow signals in benign ovarian cysts, 15 had <i>PI</i> < 1.0 and no one had <i>RI</i> < 0.4; there were significant differences in the proportions of <i>PI</i> < 1.0 and <i>RI</i> < 0.4 between the two groups (<i>χ</i><sup>2</sup> = 62.68, <i>P</i> < 0.01; <i>χ</i><sup>2</sup> = 16.91, <i>P</i> < 0.01). In addition, compared with the combination of gray-scale ultrasound and transvaginal color Doppler ultrasound, gray-scale ultrasound alone had significantly lower sensitivity (51.85% <i>vs</i> 81.48%; <i>χ</i><sup>2</sup> = 16.00, <i>P</i> < 0.01), specificity (75.76% <i>vs</i> 93.94%; <i>χ</i><sup>2</sup> = 12.73, <i>P</i> < 0.01), PPV (63.64% <i>vs</i> 91.67%; <i>χ</i><sup>2</sup> = 15.90, <i>P</i> < 0.01), and NPV (65.79% <i>vs</i> 86.11%; <i>χ</i><sup>2</sup> = 12.44, <i>P</i> < 0.01) for the differential diagnosis of benign and malignant ovarian cysts. <b>Conclusion</b> Gray-scale ultrasound is effective for diagnosing ovarian cysts; however, gray-scale ultrasound combined with transvaginal color Doppler ultrasound can improve the differential diagnosis of benign and malignant ovarian cysts.
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Objective To estimate the clinical value of diagnosing early ovarian cancer by using transvaginal color doppler sonography (TVCDS ) , combined with the levels of serum tumor markers HE 4 and CA125. Methods A total of 151 patients with adnexal masses admitted for elective surgery were selected .According to the postoperative pathologic results , they were divided into ovarian cancer group (group A, 48 cases) and ovarian benign lesions group (group B, 103 cases).All patients were examined by TVCDS and the determination of serum HE 4 and CA125 level before surgery . The results were compared with pathological diagnosis after surgery . Results Serum HE4 and CA125 levels of the patients in group A were higher than those in group B .TVCDS parameters S/D, PI and RI were significantly lower in group A than in group B .The accuracy , sensitivity , specificity , positive predictive value, negative predictive value of TVCDS and HE 4+CA125 in ovarian cancer diagnosis were 94 .70%, 93 .75%, 95 .15%, 90 .00%, 97 .03%, respectively .The values were higher than the value of the sepa -rate checks .Con clusion TVCDS combined determination of serum HE 4 and CA125 level is helpful to the improvement of clinical diagnosis in ovarian cancer .
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Objective To quantitatively analyze the changes of ovarian artery blood flow volume during whole pulsation cycle in patients with polycystic ovary syndrome (PCOS) by pulsed Doppler. Methods The ovarian arteries of 80 PCOS patients were examined by transvaginal color Doppler flow image (TV-CDFI). After examination of the parameters of pulsed Doppler, the ovarian artery blood flow volume in whole pulsation cycle was calculated with velocity-time integral while considering the internal diameter ofthe blood vessels. The results were compared with those of 80 healthy women of childbearing age in the control group. Results The typical spectrum of ovarian artery blood flow in PCOS patients was highspeed low-resistance waveform. The changes ofblood flow volumeand resistance index (RI) value were not significantly different at different times of the menstrual cycle (P>0.05). However, the changes of blood flow volume and RI value in the control group were significanly different at different times of the menstrual cycle (P 0.05). Conclusion Quantitative determination of ovarian blood flow volume using blood flow whole pulsation period method can provide a relatively accurate and reliable quantitative assessment of the ovarian perfusion in PCOS patients.
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Objective To investigate the clinical value and sonographic features of locally advanced cervical carcinoma using transvaginal color Doppler ultrasound(TVCDU). Methods A retrospctive analysis was carried on 2-D sonograms. And color Doppler flow imaging(CDFI) in 106 cases, confirmed by pathology and surgery. Results In locally advanced cervical carcinoma, the characteristerics on TVCDU were cervical enlargment, cervical masses accompanying with uteral effusion and extracervical infiltrative masses.The rich cervical blood flow signals demonstrated as called “fireball" sign. In early cervical carcinoma,the cervix showed no apparent cervical enlargment. The blood flow signals were increased.The average RI was 0.41. Conclusions TVCDU which is very valuable in judging the infiltration extent and in differential diagnosis preoperatively can be used as a routine examination method before locally advanced cervical carcinoma treatment.
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Objective To evaluate the characteristics of the haemodynamics of the hysteromyoma and its diagnosis value. Methods To apply the transvaginal color doppler ultrasound to detect the blood flow parameters of the uterine artery and the muscular tumor’s peripheral and inner area from 68 patients with hysteromyoma, compared with the blood flow parameters of the uterine artery from 50 normal women so as to analyze their difference. Results (1) In the hysteromyoma group, the maximum blood flow velocity during the systolic phase (SP) and the minimum blood flow velocity during the end-diastolic phase (ED) of uterine artery are significantly higher than those in the normal group(P
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Summary: In order To evaluate whether the parameters of spiral artery blood flow, as measured by transvaginal color Doppler, may be used to assess endometrium receptivity prior to embryo transfer (ET), a retrospective study of 94 infertile women who had undergone ART treatments with different outcomes (pregnant or nonpregnant) was done. Subendometrial blood flow was evaluated. The resistance index (RI), systolic/diastolic ratio (S/D) and pulsatility index (PI) were significantly lower in those who achieved pregnancy as compared with those who did not: 0.62±0.04 vs 0.68±0.04 (P＜0.001), 2.66±0.33 vs 3.19±0.39 (P＜0.01) and 1.15±0.17 vs 1.34±0.22 (P＜0.05), respectively. Furthermore, when RI>0.72, PI>1.6, and S/D>3.6, no pregnancy occurred. These data suggest that the parameters of spiral artery blood flow could be used as a new assay in predicting endometrial receptivity before ET.
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This study was performed to assess whether measurement of uterine artery blood flow impedance(the pulsatility index[PI] and resistance index [RI]) as determined by transvaginal color Doppler ultrasound on the day of oocyte retrieval in patients undergoing in vitro fertilization (IVF) can predict successful pregnancy. From August 1995 to January 1997, ninety-two infertile women with tubal or peritoneal factor infertility who had undergone IVF during controlled ovarian hyperstimulation(COH) cycles were allocated to the study group. The COH using luteal long protocol of GnRH agonist was used in all patients. Transvaginal color Doppler assessment of uterine artery blood flow impedance(PI and RI) on the day of oocyte retrieval was done. When the patients were grouped into pregnant(n=31) and nonpregnant(n=61), the mean value of PI and RI of the nonpregnant group were significantly higher than those of the pregnant group(2.86+/-0.62 vs 2.47+/-0.35 and 0.88+/-0.05 vs 0.85+/-0.04). The patients were also grouped according to whether the PI was low(1.00 to 1.99), medium(2.00 to 2.99), or high(>or=3.00). The pregnancy rate were 33.3%, 44.8% and 10.7% for the low, medium, and high PI groups, respectively, and the pregnancy rate of the medium PI group was significantly higher than that of high PI group. The embryo implantation rates were 11.5%, 15.2% and 4.0% for the low, medium, and high PI groups, respectively, and the implantation rate of medium PI group was significantly higher than that of the high PI group, too. There was no correlation between the mean PI and RI value and serum E2 concentration on the day of hCG administration, or endometrial thickness measured on the day of oocyte retrieval. In conclusion, we fond that the measurements of uterine artery blood flow impedance(PI and RI) on the day of oocyte retrieval might predict subsequent pregnancy and implantation rates and also contribute much to effective management of infertile couples.