THE BLOOD-CIRCULATION OF MALIGNANT AND BENIGN-TUMORS OF THE GENITAL INTERIOR AS A DIAGNOSTIC-TOOL

Background: Malignant tumours usually display a blood circulation diff erent from that of benign ones. This fact can be used in sonographic d ignity diagnostics. A prerequisite is a technology capable of detectin g this difference which becomes evident in the smallest blood vessels, where flow is extremely slow. Patients and Method: The Sonolayer SSH 140A (Toshiba) and the Quantum 2000 (Siemens) devices were used. These systems are in a position to detect slow blood flow in the tissue tes ted. We examined the very small vessels in the tumour which cannot be identified by black and white ultrasound image but only with the colou r Doppler. The colour pixels which we found in or around the tumour in the colour mode were examined with the pulsed Doppler in order to qua ntify the blood flow. The resistance index (RI) was calculated from sy stole and diastole. The lowest RI was used for the evaluation. 51 fema le patients with ovarian tumours (29 malignant, 22 benign), 41 patient s with transmutations of the endometrium (25 malignant, 16 benign), 3 patients with sarcoma, 12 patients with myoma and 39 patients with tra nsmutations of the cervix (24 malignant, 15 benign) were preoperativel y examined and the result was correlated with the dignity. None of the patients was treated with hormones. Results: The following RI values were measured: ovarian tumours: malignant 41%, benign 77% (premenopaus e: 45%); endometrial findings: malignant 49%, benign 66% (premenopause : 51%); sarcoma/myoma uteri: sarcoma 33%, myoma 35% (premenopause: 34% ); cervical findings: malignant 51%, benign 78% (premenopause: 52%). A ccording to these results the division into premenopause and postmenop ause is decisive. As our results demonstrate, differentiation before t he menopause is barely possible due to the blood circulation pattern p resent at this stage, whilst in the postmenopausal status the distinct ion between benign and malignant tumours becomes highly significant. C onclusion: The organs of the genital interior have physiologically a h igh circulation of blood in the premenopause. Therefore, the differenc e between benign and malignant transmutations is low. Thus we can see a significant difference between the blood flow in benign and malignan t tumours of the uterus and ovary in the postmenopausal women but no s ignificant difference in the premenopausal woman. The colour Doppler e xamination is able to improve the dignity diagnostics in postmenopausa l women. We could not verify a differentiation between sarcoma and myo ma by Doppler examination. If all the restrictions listed are taken in to consideration, the blood circulation diagnostics of transmutations of the genital interior in the postmenopause will be able to make an i mportant contribution to dignity diagnostics.