CLASSIFICATION OF ADNEXAL TUMORS BY TRANSVAGINAL COLOR DOPPLER

The purpose was to evaluate the validity of transvaginal color Doppler sonography for differentiating between benign and malignant ovarian t umors. Color Doppler and Duplex measurements were obtained in 212 (144 benign, 68 malignant) ovarian and tubarian tumors preoperatively. One hundred and thirty-one patients were postmenopausal and 81 premenopau sal. An ATL UM9/HDI was used. The following criteria were analyzed: mi nimum and mean resistance index and pulsatility index, number and dist ribution of tumor arteries, diastolic notch, and the maximum, minimum, mean, and sum of all peak systolic, maximum enddiastolic, and time-av erage maximum velocities, Most criteria showed highly significant diff erences between benign and malignant tumors with variable overlaps, RI (min) gives a sensitivity of 80%, specificity of 69%, and accuracy of 75% for postmenopausal patients and 80, 59, and 67% for pre- and postm enopausal patients, respectively, PImin gives equivalent results. The number of tumor arteries and the maximum flow velocities increase the accuracy, The summation of all flow velocities gives the best result w ith a sensitivity of 93%, specificity of 85% and accuracy of 87% for p ostmenopausal and 91, 76, and 80% for pre- and postmenopausal tumors, respectively, Flow data show mo relevant differences between low malig nant potential tumors and ovarian carcinomas, Serous cystadenomas and benign teratomas show higher differences than mucinous cystadenomas, f unctional cysts, and endometriomas in comparison to malignancies. A se parate analysis of pre- and postmenopausal tumors is important, Differ entiation seemed better for post- than for premenopausal tumors, The f our flow criteria (RI(min), number of tumor arteries, and maximum and sum of all peak systolic velocities) seemed appropriate for tumor diff erentiation. However, this study confirms that a single measurement is not: sufficient Co differentiate ovarian lesions. Measurements of flo w velocities (e.g., maximum and sum of all peak systolic velocities) a re superior compared with RI(min) and PImin. (C) 1996 Academic Press, Inc.