In the last article we learned about the need for ovarian cyst surgery, but many patients still don’t understand what the pre-operative tests are for, and if they are done to know whether the cyst is benign or malignant. Here we say the same thing. 1, B ultrasound: for the diagnosis of ovarian cysts, B ultrasound is undoubtedly the most simple and easy to use diagnostic method. First of all, ultrasound examination is best to avoid ovulation, as we mentioned earlier that most physiological cysts are related to the menstrual cycle, so examination within a week of menstrual cleansing can better determine whether it is a physiological or pathological cyst. Secondly, ultrasound can not only see the location, shape and size of the cysts, but also determine the internal composition of the cysts. Usually the cyst has a liquid component inside, and if it appears to have a solid component or shows abundant blood flow, we should suspect whether it is a malignant cyst and need to further confirm the diagnosis. The accuracy rate of ultrasound examination can reach 90%, especially for chocolate cysts and ovarian teratomas, but the diameter is less than 2 cm which can be easily missed. 2.CT and MRI: Compared with ultrasound, CT and MRI can observe the morphology of cysts and whether there are lymph node metastases more clearly. In benign cysts, most of them have clear and smooth borders and usually no lymph node metastasis; while in malignant tumors, most of them have irregular outline, tangled with surrounding tissues, or accompanied by ascites, and may have lymph node metastasis. 3.Tumor markers: Although there is no exclusive marker for malignant ovarian cysts, such as CA125, AFP199 and methotrexate AFP, etc., are still useful as a guide to determine the benignity and malignancy of cysts – if they are malignant, the values of these indicators will be significantly higher. 4.Laparoscopy: It can provide a visual judgment of the morphological structure of the cyst and the relationship between the cyst and the surrounding organs. And a multi-point biopsy is performed on the suspected area, and the abdominal fluid is aspirated for cytological examination (to check whether there are shed cancer cells in the abdominal fluid). 5.Pathological biopsy: You may also ask whether the benignity or malignancy of the cyst can be 100% clear after these examinations. Maybe after the above series of examinations, the doctor has 99% certainty, but the last 1% still needs to be verified by the pathological results after surgery. Pathological biopsy is to make ultra-thin sections of the excised cyst tissue and place them under a microscope for careful observation, so as to know what kind of changes have occurred in this part of the tissue. So how do you operate on ovarian cysts next? Minimally invasive laparoscopic surgery is currently the first choice, and the following article gives a detailed introduction.