BLOOD-SUPPLY OF MALIGNANT AND BENIGN-TUMO RS OF THE INNER GENITAL-TRACT

Malignant tumours differ mostly from benign lesions in their blood sup ply. This fact can be used in the sonographic diagnosis of the tumour status. This, however, depends on the availability of ultrasound equip ment, capable of demonstrating this difference, which can only be dete cted in smallest blood vessels, in which the blood flow is extremely s low. We employed the Sonolayer SSH 140A (Toshiba, Japan) and the Quant um 2000 (Siemens, Germany) for diagnosis of lesions of the female inne r genital tract. Both instruments could visualize the slow blood flow velocities in the tissues examined. Diagnosis of blood circulation in tumours of the inner genital tract thus seems less dependent on the te chnology employed as is the case in examining the breasts. 41 patients with ovarian tumours, 31 with endometrial pathology, and 33 with cerv ical lesions were examined preoperatively. Findings were correlated to histology. The lowest resistance index (RI) measured was evaluated. T he following RI values were found: Ovarian tumours: malignant 46 %, be nign 78 % (49 %) Tumours of the corpus uteri: malignant 54 benign 65 % (55 %) Cervical lesions: malignant 55 %, benign 79 % (58 %) Results i n premenopausal women with non-malignant lesions are specified in brac kets. Pre- and postmenopausal status proved essential. When compared t o breast findings, the difference between benign and malignant tumours of the inner genital tract is less pronounced due to the fact, that, physiologically, these tissues are characterised by a higher blood sup ply. Differentiation was thus almost impossible in premenopausal women . However, in menopausal patients, a highly significant difference bet ween benign and malignant tumours was found, which could serve as basi s for tumour status prognosis. Hormone therapy in the post-menopause m ay, however, influence blood supply so much, that differentiation agai n becomes almost impossible. Despite these problems still inherent to the method, ultrasonic examination of blood supply in lesions of the i nner genital tract seems to be a valuable procedure for tumour status prognosis in postmenopaused patients.