SERIAL ASSESSMENT OF ADNEXAL MASSES WITH TRANSVAGINAL COLOR DOPPLER SONOGRAPHY

Transvaginal color Doppler sonography (TV-CDS) was performed on 64 wom en with adnexal masses at 3, 6 and 12 weeks after initial presentation , In 47 (72% of patients studied), the pelvic mass demonstrated a decr ease in size and increase in pulsatility index (PI) after 12 weeks, Of the patients undergoing surgery in this group, one had a tube-ovarian abscess, one diverticular abscess and one hydrosalpinx, In seven pati ents (10%), there was no change in size or PI, Three in this group had an endometrioma, whereas two had a peritoneal cyst, In five (7%), the re was no change in size and an increase in PI, One of these patients had a mucinous cystadenoma, In three (5%), there was a decrease in siz e and PI, Two of these patients had a tube-ovarian abscess, In two (3% ) patients studied, the mass showed an increase in size and decrease i n PI; both had corpora luteum cysts with acute hemorrhage, Seventy-two percent of masses with high impedance underwent regression, whereas o nly 21% of lesions with low impedance did, Only 20% of masses demonstr ating low impedance or morphologically complex structure regressed, Si xty-five percent of lesions that regressed had a significant drop in P I, whereas all the lesions that showed no change in size or enlargemen t had either no change or decrease in PI, Probability of regression wa s the greatest in young women (less than 40 years of age) and in masse s < 5 cm, Ninety-three percent of women with persistent masses that un derwent progestational suppression demonstrated regression with decrea se of PI and peak systolic velocity, Three masses that did not respond included two hemorrhagic tube-ovarian abscesses and one cystadenoma, Changes in PI were more predictive of regression (92%) than morphology or patient age, Therefore, TV-CDS was a useful parameter in schemes t o distinguish masses in those patients whose may spontaneously regress from those that might fail to regress or enlarge.