How to read the negative ultrasound report of ovarian cancer

The negative ultrasound report of ovarian cancer should focus on key indicators such as tumor morphology, blood flow signals, and pelvic fluid accumulation. The interpretation of the negative ultrasound report should be combined with imaging description and clinical indicators, with main observation points including tumor size, boundary clarity, internal echo characteristics, blood flow richness, and adjacent tissue invasion.

1. Tumor morphology

Malignant tumors often present as irregular lobulated or papillary protrusions, with a common cystic solid mixed structure, uneven thickness of the cyst wall, and rough inner wall. Benign tumors are usually round or oval in shape, with smooth and uniform cyst walls. When descriptions such as "solid components" and "separation thickness exceeding 3 millimeters" appear in the report, caution should be taken against the possibility of malignancy.

2. Blood Flow Signal

Color Doppler shows abundant blood flow signals within the lesion, with a resistance index less than 0.4, indicating active neovascularization, which is a characteristic manifestation of malignant tumors. Benign lesions have fewer blood flow signals and are mostly distributed in the periphery, with a resistance index often higher than 0.6. The terms "rich blood flow" and "low resistance blood flow" in the report need to be given special attention.

3. Pelvic fluid accumulation

When postmenopausal women experience unexplained pelvic free fluid, especially when combined with elevated CA125 levels, ovarian cancer may be considered. The description of the amount of fluid accumulation in the report should be combined with clinical symptoms, and a large amount of fluid accumulation or septate fluid accumulation is more likely to be malignant. Physiological fluid accumulation is usually small in volume and without separation.

4. Adjacent invasion

The boundary between the tumor and organs such as the uterus and rectum is blurred, and the surrounding fat gap disappears, indicating local infiltration and metastasis. The descriptions of "adhesion with surrounding tissues" and "unclear interface" in the report may reflect tumor progression. Benign lesions are often characterized by push and push growth, with clear boundaries with surrounding tissues.

5. Lymph node status

Pelvic or abdominal aortic lymph nodes with a short diameter exceeding 10 millimeters, cortical thickening with disappearance of portal structures, and the possibility of lymph node metastasis should be considered. The report should focus on the description of lymph node size, morphology, and blood flow characteristics. Reactive proliferative lymph nodes often maintain an oval shape and have portal blood flow.

It is recommended to bring a complete report to the gynecological oncology specialist for treatment. The doctor will make a comprehensive judgment based on the negative ultrasound results, tumor markers, and clinical manifestations. Regular gynecological examinations are crucial for early screening of ovarian cancer, and it is recommended for women over 40 years old to undergo annual negative ultrasound combined with CA125 testing. Maintaining a healthy lifestyle and avoiding long-term use of estrogen replacement therapy can reduce the risk of ovarian cancer. If the report indicates abnormalities, excessive anxiety should be avoided and further examinations such as enhanced CT or MRI should be promptly completed.