임상적으로 난소종양이 의심되는 환자에서 초음파검사를 실시하고 수술후 병리조직검사로 확 인된 난소암 49명을 대상으로 연령, 종괴의 크기와 위치, 경계부소견, 종양의 내부, 주위조직 과 복강내소견, 임상기 및 정확도 등을 비교하여 후향적 분석으로 다음과 같은 결과를 얻었 다. 1. 환자의 연령은 전 연령대에 걸쳐 분포하나 연령이 증가할 수록 호발하며 40대이후 (63.2%)에 많이 발병하였다. 2. 종양의 크기는 초음파상 최대 직경으로 보면 10~14cm가 38.8%, 5~9cm가 30.6%, 15~19cm 가 22.5%순으로 빈도가 높았다. 초음파소견과 수술소견상 크기의 차이는 1cm이하가 20례로 40.8%이고 5cm이상 차이가 7례로 14.3%였다. 3. 병소의 위치가 일측성인 경우는 77.5%, 양측성은 22.5%였으며 초음파상 일측성으로 나왔 던 38예중 30례(78.9%), 양측성은 11례중 10례(90.9%)가 수술소견과 일치하였다. 따라서 위 치에 대한 초음파검사의 양성예측도는 49례중 40례가 일치하여 81.6%였다. 4. 초음파상 경계부의 명확한 구분은 32례로 65.3%에서 초음파상 구분이 가능했고 총 49례 중 39례가 수술소견과 일치하여 초음파검사의 양성예측도는 79.6%였다. 5. 자궁에 유착 또는 침윤이 있는 것으로 나타난 경우가 16례 32.7%, 망과 장에 이상소견이 나타난 경우가 17례로 34.7%, 복수는 30례로 61.2%로 수술소견과 비교하여 각각 68.8%, 76.5%, 90.0%에서 일치하였다. 6. 초음파소견을 수술소견과 비교하여 임상기에 따른 양성예측도는 제 1기에서는 94.0%, 제 2기는 68.2%, 제 3기는 71.7%, 제4기는 86.0%였다. 7. 수술전 초음파진단의 정확도는 86.0%, 예민도 75.0%, 특이도는 90.1%, 양성예측도 73.5%, 음성예측도는 90.8%였다.

The ultrasound is easily available and noninvasive diagnostic method without radiation hazard. The authors studied ultrasonographic findings of 49 cases of malignant ovarian tumor proven on postoperative histopathology at the gynecologic ward in Kyung Hee University Hospital during eight years and nine months from Jan. 1981 through Sep. 1989. The results were obtained as follows: The age distribution was from 8 to 79. There appeared to be a tendency of increase according to age and more prevalent from 5th decade (63.2%). The results of preoperative ultrasonogram were that 38.8% was from 10~14 cm, 30.6% was from 5~9cm, 22.5% was from 15~19cm and 6.1% was from above 20cm in the size of masses; in the site of mass, unilateral mass was found in 77.5%, while bilateral masses were in 22.5%, in the outline of masses, 65.3% was smooth well defined, 34.7% was irregular ill defined. In cases of 32.7%, uterine involvement was shown, in 34.7%, intestinal and omental involvement and in 61.2%, ascites was shown respectively. When the ultrasonographic finding compared with histopathology, it was shown that the difference less than 1 cm was 40.8% and over 5 cm was 14.3% in the size of masses; the percentage of positive predictability was 78.9% in the unilateral masses, while 90.9% in the bilateral masses, 93.8% in the smooth well defined outline, while 52.9% in the irregular ill defined outline. And the positive predictability of uterine involvement was 68.8%, omental and intestinal involvement 76.5%, and ascites 90.0% respectively. The positive predictability of above finding in the stage I was 94.9%, stage II was 68.2%, stage III was 71.7% and stage IV was 86.0%. Ultrasonogram can determine the presence or absence of malignancy in the suspicious cases with an accuracy of 84.7%, sensitivity 75.0%, specificity 90.1%, positive predictive value 73.5%, and negative predictive value 90.8%.