COMMON PITFALLS OF ENDOVAGINAL COLOR DOPPLER FLOW IMAGING

Endovaginal color Doppler flow imaging is a relatively new technique t hat combines gray-scale sonography with duplex Doppler and color Doppl er flow techniques. However, such imaging is associated with multiple pitfalls. Technical errors are caused by improper setting of the color flow parameters. The color velocity scale, color priority, color gain , color sensitivity, and color wall filter should be adjusted to optim ize color flow information. Technical errors may result in false diagn osis of ovarian torsion, malignancy, and ectopic pregnancy. Errors in interpretation result from an inability to identify and correctly char acterize tissue vascularity. Such errors include failure to distinguis h placental from luteal flow and failure to characterize adnexal masse s accurately. In addition, functional ovarian cysts may demonstrate in creased vascularity throughout the menstrual cycle and simulate cancer . Recognition of the common pitfalls of endovaginal color Doppler flow imaging and integration of clinical and sonographic features will red uce misinterpretation and improve diagnostic accuracy.