골반내 종양이 임상적으로 의심되는 부인과환자 175예에서 1회 이상 초음파진단장치를 실시하여 임상적소견과 단층상의 소견을 비교 분석하고 추적검사나 수술후 소견으로 다음과 같은 결론을 얻었다. 1) 총 175예에서 임상적으로 자궁근종이 의심되던 39예, 자궁부속기종양이 의심되던 78예, 종괴를 겸한 골반복막염 4예,포도상기태 30예중 초음파단층상만으로 특징적인 소견을 나타 내어 단독 확진이 32예(18.2%)에서 가능하였다. 2) 175예중 자궁근종 32예와 자궁부속기종양 68예 및 포도상기태 19예등 119예(69.5%)에 서는 내진소견이나 현병력을 참조한 초음파단층상의 진단이 가능하였고 단층상에 의하여 이 차성변화, 악성도판정 또는 종괴의 정확한 크기 및 그 성질을 정확히 간파할 수 이었다. 3) 175예중 24예(12.3%)는 추적검사, 수술결과 및 병리조직검사상 초음파진단과 상이함을 확인하였다.
Although the clinical use of diagnostic ultrasound is well established, it`s value in gynecology is yet controversal. Authors experienced the 175 consecutive gynecologic patients, under the diagnosis of pelvic tumors including 45 cases of myoma uteri, 87 cases of adnexal masses, 30 cases of hydatidiform mole, 9 cases of malignant pelvic masses and 4 cases of pelvic inflammatory diseases with masses, clinically. They were assessed to the value of the ultrasonogram as the diagnostic procedure; they are divided from 3 group that diagnostic pictures with only ultrasound, adjunctive pictures in coincidence with clinical impression and the group with missed sonographic diagnosis. Final diagnosis was confirmed by operative findings and/or repeated sonographic picture and pathologic results in the clinical courses. Ultrasonogram was of great diagnostic value in myoma uteri and benign ovarian cysts among the pelvic tumors. The full bladder technic is used as an index of the differential diagnosis of solid and cystic masses. 1) As the energy volume is amplified (regulating by total gain, near gain and STC set in our apparatus), fluid filled structure remain relatively echofree while solid structure is filled up with multiple echoes. 2) Especially, soild mass such as myoma uteri is poorly penetrated with ultrasound and with only increased STC(-3), the posterior wall of uterus is clearly defined. Otherwise, cystic mass such as ovarian cyst is well demarcated with linear echoes in lower grade of energy volume. 3) In myoma uteri with pregnancy, the power of penetration in ultrasound is more attenuated than solid mass. 4) The malignant pelvic masses are not characteristic in the sonographic pictures recently. The results are as follows: 1. Diagnostic ultrasonogrphic pictures are drawed in 32cases of the 175(18.2%). That is, 7cases of 39 in myoma uteri and 10 of the 78 cases in ovarian cysts, 11 of the 30 cases in hydatidiform mole, 4 cases of pelvic inflammatory diseases with mass are confirmed by only ultrasonogram. 2. Adjunctive information including accurate size of mass, secondary change of tumor are obtained in the 32 of myoma uteri, 68 of ovarian cysts and 19 cases of hydatidiform mole. (69.5%) 3. In 24cases among the 175, the ultrasonographic diagnosis are inaccurate. (12.3%). Most of malignant pelvic tumor are not diagnostic at present. Generally, the interpretation of sonographic picture is based upon the above characteristic findings.
