Особенности ультразвуковой диагностики пограничных опухолей яичников

Abstract

Проведен анализ результатов ультазвукового обследования 847 больных опухолями яичников, из них 28 пограничными опухолями (ПОЯ). Полученные результаты свидетельствуют о достаточно благоприятном клиническом заболевания у больных ПОЯ I стадии, с начальным опухолевым процессом. Доказано, что сонография в совокупности с допплерографией является надежным методом диагностики рецидива у больных ПОЯ.

Був проведений аналіз результатів ультразвукових обстежень 847 хворих пухлинами яєчників, з них 28 граничними пухлинами яєчників (ГПЯ). Отримані результати свідчать про досить сприятливий клінічний перебіг захворювання у хворих ГПЯ 1 стадії з початковим пухлинним процесом. Доказано, що сонографія в купі з доплерографією є надійним методом діагностики рецидивів у хворих на ГПЯ.

Actuality of the topic. Ovarian tumors occupies the third place in the structure of oncological diseases of women genitals, but the mortality occupies the first place and makes 49 %. Epidemiological investigations showed, that the vivid tendency for the growth of morbidity is indicated during the last decades, ovarian tumors are met in all age groups, beginning from the early juvenile age up to senile, more often the tumors are identified at women of reproductive period, that’s why the tumors represent not only medical problem but also a social one. Borderline ovarian tumors (BOT) occupies an important place among new formations of ovaries, so called carcinomas with low potential of malignancy. According to modern data, among all other ovarian tumors, borderline forms make from 5 up to 20 %. Nowadays in modern society and modern facilities, transvaginal echography is an obligatory method of diagnostics of all women with suspicion for the presence of tumor or tumoral formation of ovaries. The aim of investigation. To study the peculiar features of Ultra Sound Diagnostics of borderline ovarian tumors for the working out of modern principles of prognosis of clinical flow and for working out of treatment tactics for this category of patients. Materials and methods. During a period from 2006 up to 2011, according to statistics, among the total amount of 847 patients with malignant epithelial, non epithelial ovarian tumors of I IV stages in the Lugansk Regional Clinical Oncological Dispensary(LRCOD) pure carcinomas were diagnosed at 658(77,6 %) patients, non epithelial malignant new formations – at 189 (19,9 %) cases, BOT were identified at 28 (3,3 %) patients. The age of the patients with BOT varies from 20 up to 89 years old, the average age is 44,7 ± 1,8 years old. The results of investigation and their discussion. With the aim of identification of the diagnostic value of echography of BOT, 28 patients with the morphologically confirmed diagnosis of this pathology were investigated Bilateral process was stated in 8 (27,6 %) observations. Carried out investigations allowed to identify the following characteristic signs of those ovarian tumors: 1) the presence of fragmentary thickened or hacked septum in liquid state; 2) the appearance of dense growth at the septum of liquid formation with fringed surface; 3) the identification of small bilateral formations with papillary growth along septum and along internal surface in combination with ascites the residual of papillary formations after the removal of borderline tumors. Sonographic manifestations of the residual of BOT are the tumoral nodes with diameter from 0,5 up to 1,5 cm of small grained or “spongy” solid structure, round or incorrect form, which are localized in the part of vesical — uterine folder or over a vagina stump and also in the lateral channels. The tumors with the sizes more then 2 cm very often have solid or cystic-solid structure. During the supervision over patients in Lugansk Regional Clinical Oncological Dispensary from 2010 to 2012, which were operated for borderline ovarian tumors, five residuals of BOT were observed and identified during Ultra Sound. Two cases were represented by the ultra sound picture of ascites liquid mainly in the small pelvis and moderate amount of ascites liquid intra loop in the abdominal cavity. Conclusion. Borderline ovarian tumors have characteristic ultra sound peculiarities, which were definitely proved during surgical intervention. Ultra Sound Diagnostics with the usage of doplerography, the identification of onco marker CA – 125 are obligatory for timely diagnostics of the residual of the disease.