Ultrasonic evaluation of therapeutic response in tumors: Its value and implications

Not only may ultrasound demonstrate the presence of a tumor mass at various sites in the abdomen, but it may also be useful in measuring the size of the mass. The rate of tumor growth or regression was followed by ultrasound in 28 patients with ovarian carcinoma undergoing chemotherapy. The ability of ultrasound to make precise measurements of tumor size is discussed, and the value of these measurements is explored. This quantification may be valuable in the assessment of therapeutic response in pelvic cancer, and the technique may be applicable to other intra-abdominal mass lesions.     

CT findings in metastatic ovarian tumors from gastrointestinal tract neoplasms (Krukenberg tumors)

The computed tomographic (CT) findings are reviewed in 7 patients with metastatic ovarian tumors from gastrointestinal tract neoplasms (Krukenberg tumors). All patients presented mixed ovarian masses. In 6 cases the masses were mainly cystic, with internal septa and focal or uniform enlargement of the cyst wall. In the seventh patient the ovarian mass appeared on the CT as mainly solid. The size of the neoplasm varied between 5 and 46 cm. Ascites was only seen in 1 case and in another the existence of a primary tumor in the sigmoid colon was demonstrated. In our cases the CT signs of ovarian metastasis were indistinguishable from primary tumors of the ovary.     

卵巢原发性类癌7例临床病理分析

目的探讨卵巢类癌的临床及病理组织学特征。方法观察总结7例卵巢原发性类癌的临床及病理学特征,并复习相关文献。结果7例患者平均发病年龄39.86岁（29～54岁）,以盆腔肿物或卵巢囊实性肿物为主要临床表现。组织学类型为甲状腺肿型2例,岛状型3例,梁索-岛状混合型2例。结论卵巢类癌是罕见的卵巢单胚层畸胎瘤,具有低度恶性。诊断中需注意与粒层细胞瘤、支持细胞瘤等鉴别,并需除外转移性类癌。     

卵巢卵黄囊瘤的声像图特征、临床病理与预后分析

目的分析并总结卵巢卵黄囊瘤（OYST）的声像图特征、临床病理特点及预后。 方法回顾性分析2010年1月至2020年12月在南京大学医学院附属鼓楼医院行超声检查、经手术病理证实的OYST患者10例,记录患者的临床资料、声像图特点、病理结果及分期、治疗方式及预后。通过与病理结果进行对照,分析各例患者超声特点,总结能够提示OYST的主要或特定声像图特征。 结果OYST患者年龄偏小（≤30岁）,肿块体积大（最大径94~265 mm）,肿瘤内部回声以实性为主,常单侧发病,形状规则,血流信号丰富,甲胎蛋白常异常增高（多数＞1000 ng/ml）。10例OYST患者均选择手术治疗,其中1例患者手术后因肿瘤全身转移伴盆腔脓肿死亡,1例合并妊娠者足月顺产一健康婴儿。2例Ⅲ A期患者死亡,2例Ⅲ C期及6例Ⅰ C期患者均无瘤生存,其中6例患者保留生育功能,化疗后3个月内均恢复正常月经,3例患者已完成生育,生育子女健康。 结论OYST具有某些特定的超声征象,正确认识其声像图特征并结合相关临床及实验室检查,对于该病的术前评估至关重要。     

卵巢血肿的超声诊断与临床价值

目的 探讨卵巢血肿的声像图特点与临床价值。方法 对32例超声诊断并经动态观察及手术病理证实为卵巢血肿的病例进行回顾性分析。结果 卵巢血肿声像图有其特征性，内部回声表现多样，短期内动态观察出现变化直至消失。本文总结分析32例声像图，根据内部回声特点将其归纳为五种不同类型：细点状回声型25％、粗网状回声型9．4％、囊实分界回声型15．6％、混合回声型37．5％、单纯囊肿型12．5％。结论 认识卵巢血肿独特的声像图特点，注重短期内超声复查，并与卵巢其它肿物相鉴别，可提高其诊断率，减少误诊的发生。     

Sonographic appearance of Krukenberg tumor from gastric carcinoma

Sonographic findings in 16 cases of Krukenberg tumor from gastric carcinoma were analyzed. The patients' ages ranged from 25 to 52 years (mean 42 years). The tumor involved both ovaries in 14 patients with asymmetrical masses in 9 of 14 cases. Ascites was noted in 15 cases. Echogenicity of the tumor varied from solid to predominantly cystic: solid in 8, mixed in 6, and predominantly cystic in 2 cases. Solid masses tended to be smaller than mixed or cystic masses. The primary gastric carcinoma had been diagnosed before emergence of the tumors in only 7 cases. The findings suggest that in relatively young patients with ovarian mass, particularly bilateral tumors, careful evaluation for gastrointestinal tract involvement should be done.     

CT和MRI诊断男性盆腔原发肿瘤

目的 探讨男性盆腔原发性非脏器来源肿瘤的CT及MRI表现。方法 回顾性分析经手术病理证实的28例原发性盆腔非脏器来源肿瘤的CT与MRI表现。结果 28例中,良性14例、恶性14例;肿瘤呈类圆形或椭圆形15例,形态不规则13例;边界清楚16例,边界不清12例;实质性17例,囊实性7例,囊性4例;增强扫描中均匀强化5例,不均匀强化23例。6例病灶内可见钙化,其中畸胎瘤3例,神经鞘瘤3例。结论 男性盆腔原发性非脏器来源肿瘤的病理组织类型多样,部分肿瘤具有典型影像学特征表现。     

Management of intra-abdominal organ injury following blunt abdominal trauma in children

Objective To evaluate the strategy of a combined diagnostic and therapeutic approach in children with intra-abdominal organ injury following blunt abdominal trauma.Design Retrospective clinical study.Setting Pediatric intensive care unit of an university hospital.Patients 38 children with documented intra-abdominal injury.Intervention Initial non-surgical treatment by a team of pediatric intensivists, radiologists and surgeons.Measurements and results Physical examination, oriented blood and urine tests, plain abdominal film, abdominal ultrasound (US) and computed tomography (CT) with contrast. US documented intra-abdominal fluid in 30 and initial organ lesion in 14 out of 31 patients evaluated. Abdominal CT demonstrated the precise organ lesion in 34 out of 36 patients examined with solid organ lesion. Early laparotomy was needed in 7 because of severe shock, pneumoperitoneum and ruptured diaphragm, and delayed surgery in 6 patients. All 38 patients regained a normal life.Conclusions The stepped diagnostic approach combined with initial non-surgical treatment by a team provided accurate diagnosis and appropriate treatment. Abdominal US, by demonstrating free intra-abdominal fluid is very sensitive to detect patients with intra-abdominal organ injury, CT scan with contrast is needed to give precise information of specific organ lesions.     

Evaluation of abdominal lymphoma by ultrasound

Ultrasonography was utilized in 13 patients with lymphoma of the bowel, the liver, spleen, and abdominal lymph nodes. The lymphomatous tumors were (except in one patient with Burkitt's lymphoma) ultrasonographically anechoic or hypoechoic and showed very good echo transmission. In 6 out of 13 patients, lymphography was negative, or there was no evidence of enlarged retroperitoneal lymph nodes by ultrasound or computed tomography. In these patients, abdominal lymphoma in other areas was shown by ultrasonography. After a base-line had been obtained, the therapeutic effect or progression of the tumor could be followed simply by ultrasound.     

Ultrasonic evaluation of radiation therapy ports.

Radiation therapy is useful in the palliative treatment of large, unresectable abdominal and pelvic malignancies. The purpose of this study is to evaluate the effectiveness of B mode ultrasound scanning as an adjunct in radiation treatment planning of these patients. Fifty-one patients with large abdominal or pelvic masses had radiation therapy ports established using findings from surgery, radiographs, and physical examination. All the patients then had B mode ultrasound examinations. The position of the therapy ports was marked on the echogram. Thirty-one of the 51 patients studied (61%) had evidence of extension of tumor beyond the therapy ports. This was often due to "iceberging", i.e. when the deep portion of the tumor was considerably larger than the palpable margins of the superficial portion. B mode ultrasound scanning is a valuable adjunct in planning palliative radiation therapy of patients with large, unresectable, abdominal and pelvic malignancies.     

CT诊断小儿腹腔型隐睾肿瘤

目的 探讨MSCT诊断小儿腹腔隐睾肿瘤的价值。方法 回顾性分析手术病理证实的8例小儿腹腔隐睾肿瘤的MSCT表现。结果 8例小儿腹腔隐睾肿瘤6例位于右侧、2例（1例左侧隐睾肿瘤扭转至右侧腹腔）位于左侧。8例均表现为腹腔卵圆形软组织肿块,其中3例肿瘤长轴与睾丸下行途径一致。6例畸胎瘤表现为囊实性肿物,其内可见脂肪、钙化（骨化）;2例卵黄囊瘤表现为巨大囊实性肿块,其内见不规则液性坏死,可见丰富肿瘤血管。结论 与成人不同,小儿腹腔隐睾肿瘤多为畸胎瘤或卵黄囊瘤,其MSCT表现具有一定的特征,结合病史可做出定性诊断。     

彩色多普勒超声诊断卵巢内胚窦瘤

目的 探讨彩色多普勒超声诊断卵巢内胚窦瘤的价值.方法 分析51例经手术病理证实的卵巢内胚窦瘤患者的临床及彩色多普勒超声资料.结果 本组卵巢内胚窦瘤15.69%为单房囊型,21.57%为多房囊型,39.22%为蜂窝型,23.53%为实质型,彩色多普勒超声显示实质型及蜂窝型血流信号丰富,阻力指数较低.结论 卵巢内胚窦瘤的彩色多普勒超声声像图具有一定的特征性,紧密结合临床可明显提高该病的诊断率.     

High-intensity focused ultrasound treatment for intra-abdominal desmoid tumors: a report of four cases

Desmoid tumors are rare clonal fibroblastic proliferations that can arise at abdominal or extra-abdominal sites. Complete surgical resection is the primary treatment for resectable desmoid tumors, but a high rate of local recurrence has been reported even after complete resection. For patients with a recurrent tumor, the goals of treatment are to control the recurrence, maintain quality of life, and prolong survival. Radiofrequency ablation, radiotherapy, chemotherapy, and other medical therapies can be used as alternative methods, but there are considerable controversies over the roles of these methods in the management of desmoid tumors. High-intensity focused ultrasound (HIFU) is a minimally invasive and effective method for treatment of solid tumors. We used HIFU to treat four patients with intra-abdominal desmoid tumors from June 2011 to September 2013. Post-procedural pain was seen in all patients. One patient had an intra-abdominal abscess and another suffered a slight injury to the femoral nerve. The patients were followed up for 19–46 months (mean 34 months) until April 2015. The tumor in one patient disappeared, and no tumor progression was observed in the other patients.     

Abdominal ultrasound in patients with acute right upper quadrant pain

Ultrasonography was performed as the first imaging procedure in 100 patients who presented with acute right upper quadrant pain suggestive of cholecystitis or cholelithiasis. In the final analysis 46 patients were found to have gallbladder disease (40 patients with cholelithiasis, 5 with acalculous cholecystitis, and 1 with a cholesterol polyp in the gallbladder). In 22 of 54 patients with a normal gallbladder, other abdominal disease was found. The error rate for ultrasound was 5%, and in 4 patients ultrasound was not the suitable procedure for the diagnosis. In 91 patients the ultrasonographic diagnosis was correct.     

卵巢原发性恶性黑色素瘤1例及文献复习

目的 探讨卵巢原发性恶性黑色素的临床病理特征,及其与卵巢转移性肿瘤的鉴别诊断。方法 对１例原发于卵巢囊性畸胎瘤的恶性黑色素瘤标本,通过光镜及免疫组化等方法进行病理组织学观察。结果 组织学特征为：肿瘤细胞大小不等,形态多样,界限不清,呈透明细胞和／或印戒细胞样;瘤细胞内外可见一些粗大的黑色素颗粒,瘤组织内血管较多,核分裂现象多见,〉１０个／１０ＨＰＦ。免疫组化ＨＭＢ４５、Ｖｉｍｅｎｔｉｎ及Ｓ－１００     

Ovarian fibroma: findings by contrast-enhanced MRI

Ovarian fibromas are solid neoplasms that are difficult to differentiate radiologically from uterine leiomyomas. In this report, we describe the contrast-enhanced magnetic resonance imaging features of a 13-cm-diameter solid pelvic mass that allowed us to make the prospective diagnosis of ovarian fibroma. Received: 16 April 1996/Accepted: 7 June 1996     

Secondary ovarian tumors: spectrum of CT and MR features with pathologic correlation

The ovaries represent common sites for metastatic disease. The common primary sites for metastatic disease to the ovaries include the colon, stomach, breast, and the genitourinary tract. Hematologic malignancies, including lymphoma and leukemia, also involve the ovaries. Ovarian metastasis may occasionally represent the initial manifestation of disease, especially in cancers of the gastrointestinal tract. The accurate diagnosis of this condition is always crucial since the misinterpretation of such tumors may cause significant adverse consequences for patients. CT and MR features of secondary ovarian tumors differ according to the origins of the primary malignancies. The great majority of metastases from gastric cancer are Krukenberg tumors, which are typically bilateral and characterized by lobulated solid tumors. Metastases from colon cancer are usually cystic tumors with solid components of variable size. Metastases from appendiceal tumor may present as ruptured mucinous ovarian tumors associated with pseudomyxoma peritonei. Metastatic tumors from breast cancer are characterized by the relatively small size of the lesion. Ovarian involvement by hematologic malignancies is typically bilateral, homogeneous solid masses. Recognition of radiologic features of a variety of secondary ovarian tumors is beneficial for suspecting the secondary tumors under certain clinical conditions, and thus determining the appropriate management of the patients.     

Ultrasound evaluation of the posthysterectomy pelvis

Ultrasound findings in pelvic examinations of 80 patients with a previous hysterectomy are evaluated. Ovaries were located low in the pelvis close to the superior end of the vagina in a large number of patients. An enlarged ovary contiguous with the superior end of the vagina may simulate the appearance of the uterus. Occasionally, the superior end of the vagina or cervical remnant (in patients with a supracervical hysterectomy) may be prominent and should not be mistaken for a pathologic mass.     

颈部神经鞘膜瘤的超声诊断及其价值

应用超声诊断检查了４１例颈部神经鞘膜瘤患者，其中１７例还应用了彩色多普勒血流显像对瘤体内的血供情况进行了观察。结果示：超声显像具有较明显的规律性特征，其诊断结果经与手术及病理结果对比，正确率为９４．４％。认为超声对该瘤的诊断及鉴别诊断具有简便、迅速、准确的优点，值得临床推广使用。     

Sonographic diagnosis of primary malignant tumors of the fallopian tube

The purpose of this study is to illustrate the sonographic features of primary malignant tumors of the fallopian tube and to heighten awareness of their existence. This is a retrospective review of the imaging and clinical files of 7 patients with a primary malignant tumor of the fallopian tube found in the medical records of 4500 patients with primary gynecologic malignancies seen during the last 6 years at the authors' institution. All patients had transvaginal sonography before surgery. Images were reviewed to determine common features of this rarely encountered pathology. Transvaginal sonography showed normal ovaries in 5 patients in association with a discrete solid adnexal mass in 4. The fallopian tube origin of the mass was shown directly in 2 of these 4 patients and was inferred in the other 2 on the basis of a mass in the expected location of the fallopian tube. In the 3 patients without a discrete adnexal mass, there were more extensive changes, including large, solid adnexal masses of unknown origin (n = 2) and gross peritoneal carcinomatosis (n = 1). Fallopian tube malignancies should be considered when unexplained solid masses corresponding with the expected location of the fallopian tubes are seen in association with normal ovaries. Disease dissemination may show carcinomatosis or more extensive pelvic disease.