Properly diagnosed tumor-like formations of the ovaries facilitate the correct selection of patients who may not require surgery, or choose surgery with minimal access if such intervention is required. Subjective assessment of the features of tumor-like formations with the help of ultrasound diagnostics, including compression elastography, proved to be highly effective in the differential diagnosis of bulky ovarian formations. All tumor-like formations have their sonographic features that allow making a reliable diagnosis of a particular formation. The article reveals data on the diagnostic significance of multiparametric ultrasound imaging in the detection of ovarian tumor-like formations. A detailed sonographic picture of tumor-like formations in B-mode, color, and pulse Doppler mode and compression sonoelastography mode was analyzed. This examination was especially relevant for women of reproductive age, as it depended on the further tactics of treatment of each patient. For all types of tumor-like formations ovaries, a qualitative feature was determined - elastotype on the Ueno scale and the index of stiffness (Strain Ratio) - a quantitative indicator. Follicular cysts, endometrioid and periovarian cysts were found to belong to the 0 elastotype. Cysts of the corpus luteum belonged to the II elastotype on the Ueno scale. The lowest values of the stiffness index were seen in follicular and periovarian cysts, and the highest value was observed in endometrioid cysts. Our results have shown that ultrasound examination of ovarian tumors is an accurate and highly informative method.
Properly diagnosed benign ovarian tumors are a condition for optimal treatment tactics. Qualitative assessment of signs detected by multiparametric ultrasound, including compression elastography, is highly effective in the differential diagnosis of benign ovarian tumors. Our study became especially relevant for women in the reproductive period, because the correct diagnosis influenced the choice of surgical treatment in order to preserve the ovarian reserve. A comprehensive radiological study of 51 women with benign ovarian tumors was performed. The age of patients averaged 37.3 ± 8.7 years. In the structure of benign ovarian tumors, the frequency of serous cystadenoma was 31.38%, serous superficial papillomas - 25.49%, mucinous cystadenoma - 17.65%, mature teratomas - 15.68%, fibroma - 9.8%. Ultrasound was performed on a HITACHI ALOCA ARIETTA 70 using a cavitary multifrequency sensor with a frequency of 7.5-10 mHz and a sector sensor with a frequency of 2-5 mHz. The article analyzes the detailed sonographic picture of these formations in B-mode, Doppler mode and compression sonoelastography mode. Color and energy Doppler mapping techniques, as well as pulsed Doppler mode, which gave a quantitative characterization of blood flow, were used to study blood vessels. Vessel localization was determined using color Doppler mapping, and detailed qualitative assessment of blood flow loci was determined using energy Doppler. For all types of benign ovarian formations, a qualitative feature was determined - elastotype on the Ueno scale and stiffness index - Strain Ratio (coefficient of deformation) - a quantitative indicator. It was found that serous and mucinous cystadenomas belong to 0 and I elastotype on the Ueno scale, the papillary component of serous superficial papillomas was mapped with I and II elastotype, fibroids mainly belonged to II and III elastotype, and mature teratomas - to IV end V elastotype. Quantitative deformation rate for all benign ovarian tumors ranged from 0,63 to 24,9. Thus, the cardiac index of stiffness in serous cystadenomas was 0.92 ± 0.46, and in mature teratomas - 16.7 ± 8.4. The increased density of the latter in comparison with other representatives of benign formations can be explained by the presence in their structure of such elements as fibroblasts, bundles of spindle-shaped cells and bundles of collagen fibers (fibroids), bone and cartilage (mature teratoma). In addition to all the above research methods, the mobile application IOTA ADNEX 2014 was used, which helped to calculate the risk of malignancy. This is a simple calculator, which loads the data of the ultrasound examination, the patient's age, the level of CA-125. Our results showed that ultrasound examination of ovarian tumors is an accurate and highly informative method for stratification of risks according to the O-RADS classification. For stratification and the ultrasound risk management system, the O-RADS system was guided by consensus guidance from the American College of Radiology, which reduces or eliminates ambiguity in the interpretation of data in ultrasound protocols and provides a more accurate definition of ovarian malignancy. The O-RADS working group includes 5 categories: O-RADS 0 - incomplete examination score, O-RADS 1 - normal unchanged premenopausal ovary, O-RADS 2 - almost always benign (risk of malignancy - <1%), O-RADS 3 - the presence of education with a low level of malignancy - from 1 to 10%, O-RADS 4 - medium risk of malignancy - from 10 to 50% and O-RADS 5 - education with a high level of malignancy -> 50%.
In Ukraine ovarian cancer ranks third among pelvic malignancies in women of childbearing age and ranks first in the structure of mortality of women from oncogynecological pathology. The aim of the study – to increase the diagnostic value of multiparametric ultrasound examination of ovarian malignancies using compression sonoelastography. Material and methods. A comprehensive radiological study of 48 patients with ovarian cancer was performed. The average age of patients was (45.22 ± 4.08) years. Ultrasound was performed on a HITACHI ALOCA ARIETTA 70 using a cavitary multifrequency sensor with a frequency of 7.5-10 mHz Compression elastography was used to assess the rigidity of the detected formation. Results. In 30 (62.5%) women in the sonoelastography mode different elastotype was detected, because the liquid component had a blue-green-red color corresponding to 0 elastotype, and the solid component and papillary growths were mapped mostly blue, rarely with green admixtures, ie. had IV-V elastotype on the UENO scale. The hardness index of the solid component ranged from 4.3 to 46 um.od. In 18 (37.5%) patients malignant were mapped in blue, which corresponded to the V elanotype according to UENO and had a high hardness index, which ranged from 5.2 to 56 um.od. All of these formations were classified as high-risk - O-RADS 5, as all formations were characterized by ultrasonic descriptors with a high degree of prediction of malignancy. Conclusions. Innovative technology of sonoelastography provides qualitatively new information about the elasticity of tissues and allows to assess the stiffness of ovarian tumors with high accuracy and specificity.
Rapid and accurate diagnosis of various lung changes caused by SARS-Co V-2 is extremely important and relevant, as it will allow timely action to take the necessary measures to treat and stop the spread of lesions. Ultrasound diagnosis allows you to quickly, non-invasively, and cheaply conduct research that is accurate and effective enough to make or confirm a diagnosis. The article highlights the main structural changes in the lungs found in 86 patients with a positive PCR test for coronavirus virus. The following sonographic signs were observed during the study: B-line (in 54% of patients), white lung effect (in 20.6% of patients), consolidation (11 people – 17.5%), of which 6 patients with consolidation less than 1 cm and 5 patients had consolidations greater than 1 cm, pleural effusion was observed in 7 patients. Our research is important both in terms of increasing the informativeness of the diagnosis for physicians and patients, for whom it is important to quickly, non-invasively, and economically compare, detect disease and begin treatment promptly.
Properly diagnosed benign ovarian formations are a condition for appropriate treatment choice. Qualitative assessment of signs detected by multiparametric ultrasound, including compression elastography, is highly effective in the differential diagnosis of benign ovarian formations. Our study became especially relevant for women in the reproductive period since the correct diagnosis influenced the choice of surgical treatment in order to preserve the ovarian reserve. The detailed sonographic aspect of these formations in B-mode, Doppler mode and compression sonoelastography mode is analyzed in the article. Color Flow Mapping, power Doppler and pulsed wave Doppler were used to study blood vessels. Pulsed wave Doppler characterized blood flow quantitatively. Color Flow Mapping was used to determine vessels localization, and power Doppler was used to provide a detailed qualitative assessment of blood flow loci. Elastotype according to the Ueno scale as a qualitative feature and Strain Ratio (coefficient of deformation) as a quantitative indicator were determined for all types of benign ovarian formations. Serous and mucinous cystadenomas were found to belong to elastotypes 0 and I according to the Ueno scale, the papillary component of serous superficial papillomas was mapped as elastotype I and II, fibroids predominantly belonged to elastotype II and III, mature teratoma appertained to elastotypes IV and V. Quantitative coefficient of deformation for all benign ovarian formations ranged from 0.63 to 24.9. According to our results, ultrasound examination of ovarian formations is an accurate and highly informative method for stratification of risks in accordance with the O-RADS classification.
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