Qualificated discrimination of ovarian malignancy by diagnostic ultrasound

Ultrasonograms of 214 ovarian masses in 184 patients were studied to discriminate ovarian malignancies from benign masses and to help in developing a new scoring system using ultrasonographic findings with weight-adjusted scores. The 76 masses that showed cystic patterns only were directly determined to be benign, having an expected success rate of 97.4%. The remaining 138 masses, of which 116 showed mixed patterns and 22 of which showed solid patterns, were analyzed by the Quantification method No. 2 of Hayashi to select the effective ultrasonic findings and to obtain a good discriminant function. Eleven findings (items) expressing 29 categories were selected, and a discriminant function composed with a weight-adjusted score for each category was obtained as the result of the analysis. Using these functions, the 86.6% of the ovarian masses with mixed or solid patterns were correctly discriminated as being malignant, borderline-malignant, or benign. According to internal checks of all ovarian masses, the success rate was 90.2%. Then 73 ovarian masses of 65 new patients were discriminated as the external check, and a success rate of 93.2% was obtained. It is concluded that this newly developed scoring system using ultrasonic findings is useful in discriminating ovarian malignancies from benign ones.