No abstract

No abstract

Background. The crucial role of angiogenesis in tumor behavior has been studied extensively in vitro. The authors assessed the in vivo angiogenesis in ovarian neoplasms by color Doppler ultrasound and waveform analysis. Methods. The intratumor artery resistance index (RI) of 222 ovarian neoplasms referred for color Doppler ultrasound evaluation was measured, and the corresponding histopathologic diagnosis was recorded. Results. Satisfactory intratumor artery waveforms were obtained at an average of 1.12 sites in 44.7% (68 of 152) of benign tumors and at 6.28 sites in 97.1% (68 of 70) of the malignant group. Great heterogeneity in RI values existed. The RI of the intratumor artery in the benign group during the follicular phase (mean, 0.678) was significantly higher (P <0.001) than that of the lteal phase (mean, 0.414), epithelial ovarian carcinoma (n = 34; mean, 0.402), malignant germ cell tumor (n = 6; mean, 0.413), malignancy metastasized to the ovary (n = 18; mean, 0.357), and other rare malignancies (n = 4; mean, 0.435). The RI of primary ovarian malignancy (n = 41; mean, 0.411) was significantly higher than that of malignancy metastasized to the ovary (P <0.05). The RI values of epithelium‐originated neoplasms showed a significant incremental decrease from benign tumors (n = 48; mean, 0.695) toward borderline malignancy (n = 6; mean, 0.535; P <0.01), early‐stage ovarian carcinoma(n = 10; mean, 0.485; P <0.01), and, finally, to advanced‐stage ovarian malignancies (n = 29; mean, 0.398; P <0.05). Conclusions. Angiogenesis is a common phenomenon in malignant ovarian neoplasms, but the intensity of neovascularization may depend on individual tumor characteristics. The authors documented the incremental decrease of the resistance index in ovarian neoplasms, which may reflect the increase in angiogenesis intensity as an indication of malignant potential. Cancer 1994; 73:1251–6.

Summary. Absent or reversed diastolic component in umbilical artery (UA) flow velocity waveform was observed in eight fetuses with major malformations. Because of the uncorrectable fetal conditions or the parents' reluctance to terminate the pregnancy, no interventions were undertaken and eventually all eight fetuses died in utero. The interval between the abnormal waveform recording and fetal death was between 1 and 7 days (mean 3.6 days). In two fetuses with abnormal diastolic flow, analysis of umbilical vein blood obtained by ultrasound‐guided sampling revealed moderately severe acidosis and hypoxia (pH 7.228 and 7.241, Pco2 47.5 and 46.9 mmHg; Po2 14.6 and 14.7 mmHg, respectively). Our observation suggests that once the diastolic component of UA flow velocity waveforms becomes absent or reversed, the fetus is in a state of hypoxia and acidosis and fetal death is impending. This limited experience may help in formulating clinical management when using UA flow velocity waveforms in the monitoring of high‐risk fetuses.

Uterine hemodynamic characteristics assessed by color Doppler ultrasound might predict and monitor the response to chemotherapy in gestational trophoblastic tumors.