关键词: 卵巢肿瘤, 超声检查, 转移瘤

Abstract: Objective To explore the value of ultrasonic fine features in identifying the source of multilocular and multilocular-solid ovarian masses. 
Methods A total of 246 patients diagnosed with multilocular and multilocular-solid ovarian masses by ultrasound the Fourth Hospital of Hebei Medical University were selected as the research subjects. The ultrasonic fine features of these masses were observed and recorded. Combined with the clinical features and histopathological classifications, the relationship between the ultrasonic fine features and primary or metastatic ovarian neoplasms were compared and analyzed. 
Results The histological types of 246 patients with ovarian masses included primary ovarian neoplasms in 217 (88.21%) and metastatic ovarian neoplasms in 29 (11.79%) patients. Among primary tumors, 62 patients (25.20%) had benign tumors, mainly consisting of serous and mucinous cystadenomas; 27 patients (10.98%) had borderline tumors; 128 patients (52.03%) had malignant tumors, mainly consisting of serous and mucinous cystadenocarcinoma. In metastatic tumors, the primary site was mainly the colon and rectum. For clinical features, patients with ovarian metastases were older than those with primary ovarian neoplasms ［(60.80±8.04) years vs. (51.29±12.32) years, P=0.035］. Patients in primary tumor group had no confirmed history of tumors in other areas, while 9 patients in the metastatic tumor group had history of tumors in other areas when ovarian tumors were detected (P＜0.001). The proportion of patients with serum CA199≥37 000 U/L in the metastatic tumor group was higher than that in the primary tumor group, and the difference is statistically significant ［24(11.06%) vs. 17(58.62%), P＜0.001］, and there was no significant difference in other clinical features between the two groups (P＞0.05). In terms of sutble ultrasonic features, compared with primary neoplasms, patients with ovarian metastatic tumors had the characteristics of larger tumor size ［(15.7±4.80) cm vs. (9.54±3.96) cm, P＜0.001］, more than 10 cystic cavities inside the tumor (55.17% vs. 18.89%, P＜0.0001), fewer mural nodules (6.90% vs. 21.66%, P=0.007) but larger diameters ［(1.44±0.36) cm vs. (0.97±0.39) cm, P=0.031］, and lower resistance index of color doppler flow (0.46±0.07 vs. 0.61±0.13, P＜0.001). 
Conclusion In the ultrasound diagnosis of multilocular and multilocular-solid ovarian masses, especially accompanied by malignant tumors in other areas, the ultrasonic fine features can be used to improve the ability to identify the source of the masses. 

Key words: ovarian neoplasms, ultrasonography, metastatic tumor