COLOR DOPPLER SONOGRAPHY IMPROVES THE PREOPERATIVE DIAGNOSIS OF OVARIAN-TUMORS MADE USING CONVENTIONAL TRANSVAGINAL SONOGRAPHY

Objective: Conventional transvaginal ultrasound- and transvaginal colo ur Doppler flow were used to assess morphology and circulation of pelv ic masses. Study design : One hundred and nine adnexal masses in 101 w omen were examined between January 1993 and September 1994. Morphology was classified after a score published by Sassone et al. in 1991. Dop pler waveforms using the lowest resistance index (RI), the pulsatility index (PI) and peak flow velocity were used for analysis. Ninety five patients underwent laparotomy. Following histopathological evaluation best cut-off values, sensitivity and specificity were calculated. Sco re results were compared with Doppler results and a combination of bot h methods. Results: A combination of Doppler sonography and convention al transvaginal sonography led to a sensitivity of 74.0% and a specifi city of 73.7%. Eight out of 15 malignant masses were classified as sta ge I. An analysis of the false positive diagnoses showed that importan t information can be gained when Doppler sonography is performed. In p articular, on solid appearing adnexal masses, Doppler sonography leads to a high accuracy (84.6%). Conclusion: Colour Doppler sonography is not applicable in routine clinical practice, but can give important ad ditional information in specific cases. For solid appearing masses and in early ovarian malignancy, Doppler sonography facilitates the preop erative discrimination between benign and malignant processes.