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The present paper reports on the value of gynecological-clinical examinations and preoperative ultrasonography in the diagnosis of benign and malignant ovarian tumors. Out of a group of 42 patients, in all of whom "ovarian cyst" had only been diagnosed clinically, 14% were not found to be suffering from this condition at surgery. In a comparison of preoperative gynecological-clinical and ultrasonographic findings (in 68 patients) it proved possible to determine the side on which the tumor was localized, its actual size, the extent to which it was delimited from the uterus, and its consistency (whether solid or cystic) significantly better by ultrasonography (p less than 0,01). However, the results of this study indicate that 2% of the cases diagnosed ultrasonographically as "benign ovarian tumor/ovarian cyst" are likely to be ovarian carcinomas. In the group of patients with malignant ovarian tumors also (42 patients), there was a significant difference in the preoperative diagnosis "suspected ovarian carcinoma". On the basis of clinical findings it was only diagnosed in 45%, while it was found in 74% by ultrasonography (p less than 0,01). In 3 cases with ovarian carcinoma there was no pathologic palpation finding, and in only one other case was a "suspected ovarian cyst" diagnosed. By means of ultrasonography, on the other hand, all of the cases of ovarian carcinoma were classified either as "ovarian carcinoma" or as "cystic-solid/complex abdominal tumor". The most frequent diagnoses on the basis of the sonographic scan (approx. 90%) were cystic-solid ovarian tumors, followed by cystic-ventriculated ovarian tumors with solid portions and finally solid ovarian tumors with only a few cystic portions.(ABSTRACT TRUNCATED AT 250 WORDS)

The use of sonography to diagnose pathologic changes of the breast is constantly increasing. It is well known that this method can be employed to distinguish cystic from solid processes. Of greater interest is the question as to the usefulness of sonography in prognosticating the pathology of such processes. This prognosis of pathology is linked to assessment criteria which are not uniformly defined worldwide and which are also applied differently. The study reported here--an evaluation of 755 sonographic focal findings--points out the possible distinctiveness of each individual assessment criterion and indicates the degree of confidence with which malignant and benign breast processes can be distinguished. There are statistically significant differences (p less than 0.0001) in the patterns of distinctiveness of all the assessment criteria mentioned depending on whether the processes are malignant or benign. The most important criterion is the edge contour. Every sonographic focus finding should be checked with regard to its edge contour, retrotumorous acoustic behavior, echo structure, and echo density. In the dynamic part of the examination, changes in the form and structure of the finding must be recorded. The authors estimate the changes of being able to distinguish malignant from benign processes on the basis of the above-mentioned criteria as good. The guide to the classification of echographic phenomena presented here may be of help to learners.

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