PREOPERATIVE MORPHOLOGICAL AND COLOR DOPPLER FEATURES OF BORDERLINE OVARIAN-TUMORS

Objective To evaluate pre-operatively the sonographic morphology and c olour Doppler findings of borderline ovarian tumours and to compare th ese findings to those of benign and malignant tumours. Methods Pre-ope rative transvaginal and colour Doppler ultrasound examinations were pe rformed on 150 women with adnexal tumours. Pulsatility index, resistan ce index, peak systolic velocity, site, number and confluence of vesse ls were recorded. Results Fifty-six women had malignant ovarian tumour s, 74 had benign and 20 had borderline tumours. No biological, morphol ogical or demographic parameters were specifically predictive of borde rline tumours. Intratumoral vessels with a pulsatility index of below 1.0 were observed in 19 of the 20 borderline tumours; a morphological score suggested malignancy in 15 women whereas the CA125 exceeded 30 u /ml in 10 cases. Confluence of blood vessels was observed only in thre e cases. A model including intracystic complexity (either vegetations or septa), pulsatility index of less than 1.0, absence of confluence o f vessels, CA125 of less than 150 u/L, in a woman under 60 years of ag e allowed borderline tumours to be detected with 85% sensitivity, 92 % specificity and 91 % accuracy. Conclusion Borderline tumours have hae modynamics resembling those of malignant tumours but the distribution of vessels is often similar to that observed in benign tumours; this o bservation should be considered when proposing multiparameter scoring systems including colour Doppler ultrasound to identify malignancies o f the ovary. Colour Doppler findings may be of assistance in the follo w up of women after conservative surgery for ovarian malignancies.