title: Frequency and disposition of ovarian abnormalities followed with serial transvaginal ultrasonography.
abstract: OBJECTIVE
  To examine the prevalence, incidence, persistence, and resolution of ovarian abnormalities using serial transvaginal ultrasonography.
  
  
  METHODS
  A group of 39,337 women in the University of Kentucky Ovarian Cancer Screening Program were monitored with 221,576 baseline and interval transvaginal ultrasonography.
  
  
  RESULTS
  The transvaginal ultrasonogram was normal for first and all subsequent visits for 31,834 participants (80.9%), whereas 6,807 women (17.3%) had transvaginal ultrasonograms interpreted as abnormal and were monitored over 21,588 ultrasonograms. Ovarian cysts were more common in premenopausal (prevalence 34.9%, incidence 15.3%) than in postmenopausal women (prevalence 17.0%, incidence 8.2%). For the group with abnormalities, the initial transvaginal ultrasonogram was abnormal in 46.7% of the cases, of which 63.2% resolved to normal on subsequent ultrasonograms. Of 35,314 cases classified as normal on the first examination, 9.9% were abnormal on subsequent annual examinations. The abnormal findings were classified as follows: unilocular cysts (11.5%), cysts with septations (9.8%), cysts with solid areas (7.1%), and solid masses (1.8%). Many transvaginal ultrasonographic abnormalities were followed to resolution. Surgery was performed on 557 participants for 85 ovarian malignancies and 472 nonmalignancies. Over the duration of the study, the positive predictive value (PPV) increased from 8.1% to 24.7%.
  
  
  CONCLUSIONS
  Serial ultrasonography has shown that many ovarian abnormalities resolve, even if the initial appearance is complex, solid, or bilateral. Thus, it is advantageous to avoid a single transvaginal ultrasonographic abnormality as the sole trigger for surgery and to take a measured serial approach to reduce false-positive results and increase the PPV.
  
  
  METHODS
  II.
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology and the Department of Biostatistics, the University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, Kentucky.
authors: Edward J
authors: EJ
authors: Pavlik
authors: Frederick R
authors: FR
authors: Ueland
authors: Rachel W
authors: RW
authors: Miller
authors: Jessalyn M
authors: JM
authors: Ubellacker
authors: Christopher P
authors: CP
authors: DeSimone
authors: Jeffrey
authors: J
authors: Elder
authors: John
authors: J
authors: Hoff
authors: Lauren
authors: L
authors: Baldwin
authors: Richard J
authors: RJ
authors: Kryscio
authors: John R
authors: JR
authors: van Nagell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D007629:Kentucky / Q000453:epidemiology; D008875:Middle Aged; D010049:Ovarian Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D014463:Ultrasonography
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