One hundred thirty patients with 170 epithelial ovarian tumors were prospectively studied with computed tomography (CT) before surgery. Ultrasound (US) was performed in 108 patients with 138 tumors. At pathologic examination, 78 tumors (46%) were benign, 14 (8%) borderline, and 78 (46%) malignant. CT results were compared with surgical and pathologic findings in all patients. CT enabled detection of 148 of 170 tumors (87%), and US enabled detection of 118 of 138 tumors (86%). Benign serous cystadenomas (n = 42) were correctly characterized with a sensitivity of 69% at CT and 70% at US. Benign mucinous cystadenomas (n = 21) were correctly characterized with a sensitivity of 62% at CT and 50% at US. Malignancy was suggested in nine of 14 patients (64%) with borderline tumors at CT and in five of 14 (36%) at US. The overall accuracy of characterization of benign versus malignant tumors (including borderline tumors) was 94% with CT and 80% with US. In the 108 patients studied with both CT and US, the sensitivity of CT was significantly superior to that of US (P less than .03), whereas there was no significant difference in specificity (P = .125).

No abstract

Metastatic peritoneal implants were assessed preoperatively with computed tomography (CT) in 38 patients with ovarian tumors. In the 106 biopsy specimens of gross peritoneal implants and the 118 random biopsy specimens obtained from these patients, metastatic deposits were detected in 27 of 38 (71%) patients and in 104 biopsy sites. CT depicted metastatic lesions in 17 of 27 (63%) patients and in 63 of 104 (61%) biopsy sites. The three sites most commonly involved were the right subphrenic region, the greater omentum, and the pouch of Douglas. The usefulness of CT in detecting lesions depended mainly on the location of the implant and the presence of adjacent ascites, rather than on lesion size.

Association of morphologic and vascular ultrasound findings can highly suggest the diagnosis of benign or malignant papillary projection.

A case of hyperreactio luteinalis in an otherwise normal pregnancy is reported. Ascites was present, but no peritoneal implants or adenopathy were seen. Findings that would have suggested the correct diagnosis are the symmetrical and bilateral pattern of the mass, as well as the rather uniform size of the loculi, which were 1 to 3 cm in diameter.