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Ultrasound-guided ovarian cyst aspiration is an increasingly important means of diagnosingand treating ovarean cysts.We report the results of 140 ultrasound-guided ovarian cyst aspirations in112 symptomatic patients,with an age range of 19-87 years(mean 38).Cysts had benign character-istics and ranged from 4 to 20 cm in diameter.The majority of cysts were aspirated once.In 20 casescysts were aspirated twice,in five cases three times and in one case four times.The cyst aspirate wesexamined cytologically and correlated with histology where available.The only complication was an o-varian abscess,giving a eomplieation rate of 0.7%.Cytology was not found to be useful in excludingneoplastic lesions(sensitivity 46.6%.)The aspirate type was more useful.A serous aspirate was asso-ciated with a cure rate of 73.7%(45 of 61);28%(17 of 61)eventually had surgery;at surgery 9(14.75%)neoplastic lesions were found,all were benign.A haemorrhagic aspirate with no histo~ ofendometriosis was associated with a cure rate of 70.6% (12 of 17);there were 4(24%)neoplastic cystsat surgery,1 of these was malignant.Endometriotic cysts had a recurrence rate of 90%(19 of 21).Withmutinous aspirates 75%(3 of 4)were mueinous neoplasms.Aspiration was performed in 14 post-menopausal patients.Two neoplasms were found in this group and one of these was a malignant neoplasm,which had yielded a haemorrhagic aspirate.The majority of cysts even in the postmenopausal patientswere innocuous.Uetrasound-guided cyst aspiration is safe and useful in the management of ovarian cysts with benigncharacteristics.The finding of a haemorrhagic aspirate is more likely to indicate a neoplastic lesion,andespecially in the postmenopausal patient should be viewed with caution.The risk of missing a malignantlesion in non-haemorrhagie cysts with benign eharacteristies on ultrasound is negligible.
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