404 Thin-Needle Puncture Biopsy Under Two- and Three-Dimensional Echographic Control in The Diagnosis and Treatment of Ovarian Tumours

The use of diagnostic puncture of ovarian masses was considered dangerous due to the threat of malignant dissemination. But modern results of chemotherapy strike a balance between this threat and the accuracy of preoperative diagnostics of malignancy. Over 2000-2003, 158 patients underwent thin-needle puncture biopsy under echographic control; 101 of the patients had malignant tumours, and 57, benign. One-side tumours were detected in 108 patients, and two-side, in 50. Cytological material was obtained in 86% of the cases; cytological and hystological material, in 14%. Accumulation of experience and further specification of cytological criteria lead to an increase in the quality of diagnosis. The highest level of precision attained, 100%, was for specificity; the rates of accuracy and sensitivity were 71.4% and 86%, respectively. Cytological criteria for the epithelial tumours were formulated based on the content of the material of the precipitation. Consecutive use of two- and threedimensional echography in volumetric and superficial reconstruction modes, transparency adjustments, and three-dimensional angiography make this method less traumatic and more informative. This method allows to choose adequate treatment tactics, to avoid excessive chemotherapy, and to single out patients with benign and tumour-like ovarian formations for future sclerotherapy.