[Ultrasonic diagnosis of ovarian tumours (author's transl)]

Precise knowledge of the echoanatomy of the normal female pelvis is a prerequisite in the diagnosis of ovarian tumours. Diagnostic criteria for the differentiation between cystic and solid lesions are discussed. The echographic appearance of uni-, multilocular, dermoid and endometriosis cysts and of ovarian cancer is described. 183 ovarian tumours were examined in the period from January 1st, 1976 until December 31st, 1977 and the preoperative diagnosis compared with the findings at operation, both macroscopic and histological. 158 cases (86.3%) were correctly diagnosed. In 13 cases (7.1%) the diagnosis was only partially correct. An incorrect ultrasonic diagnosis was made in only 12 cases (6.6%). Out of 183 cases the side of the lesion was correctly diagnosed in 128 patients (70.0%). Localization of the tumour could not be achieved or was totally wrong in 19 cases (10.4%). Estimated tumour dimensions concurred with the macroscopic measurements of the specimen in 90.7%. A false-positive result was recorded in 7 cases (3.8%), mostly due to a full bowel simulating a cyst of barely 4 cm in diameter. In 5 cases (2.7%) ultrasonic examination failed to detect the existence of a tumour. 2 of these tumours were follicular cysts under 4 cm in diameter. 2 ovarian cancers were missed. In 1 case the ovary was only slightly enlarged and the diagnosis was made only by frozen-section histology. In the second case the tumour was erroneously interpreted as originating from the sigmoid colon. Ultrasonic diagnosis is recommended for the detection and differentiation of ovarian tumours on the basis of the good results achieved.