COMBINED EXAMINATION OF OVARIAN-TUMORS BY TRANSVAGINAL SONOMORPHOLOGYAND COLOR DOPPLER SONOGRAPHY

Transvaginal sonomorphologie and colour Doppler measurements were obta ined preoperatively in 212 adnexal tumours: 81 premenopausal tumours ( 13 malignant and 68 benign) and 131 postmenopausal tumours (55 vs 76). Tumours were divided into five different scores according to their so nomorphology [16]. Scores I and II are related to benign tumours. Scor e V represents typically malignant tumours. Scores III and IV are asso ciated with benign and malignant tumours. If score I and II are consid ered as benign and score III to V as malignant the sensitivity in pre- and postmenopausal tumours is 90%. However, the specificity is only 5 6% vs 70% respectively. In order to improve the accuracy, colour Doppl er was additionally performed in tumours with sonomorphological score III and IV. The following criteria were tested: minimum resistance ind ex (RImin), number of tumour arteries (ART), maximum (Smax) and sum (S sum) of peak systolic velocities. All criteria showed significant diff erences between benign and malignant tumours. Tumours of score III and IV were differentiated by colour Doppler with an accuracy between 66% and 81% for premenopausal and 69% to 86% for postmenopausal women. Th e combination of sonomorphology and colour Doppler increased the accur acy between 84% and 90% with a sensitivity of up to 92% in pre- and 89 % in postmenopausal patients. Sequential colour Doppler sonography as a supplement to transvaginal sonography improves tumour differentiatio n. The limitation of colour Doppler measurements to score III and IV l esions reduced the length of examination time to a reasonable extent.