EVALUATION OF OVARIAN FINDINGS IN ASYMPTOMATIC POSTMENOPAUSAL WOMEN WITH COLOR DOPPLER ULTRASOUND

Background. To evaluate the prevalence and significance of abnormal ov arian findings in asymptomatic postmenopausal women, screening for ova rian cancer with color Doppler ultrasound was performed. Methods. One thousand three hundred sixty-four asymptomatic women aged 56-61 years (mean, 59 years) were examined by color Doppler sonography. Ninety-six percent of the examinations were transvaginal and 4% transabdominal. The criteria for abnormality were an ovarian volume 8 cm(3) or greater , nonuniform echogenicity, and/or pulsatility index (PI) of the ovaria n artery or tumor vessel, if present, 1.0 or less. Repeat sonograms we re performed 1-3 months later on all patients with abnormal findings, and exploratory laparotomy was performed if a malignant tumor was susp ected. Results. Abnormal ovarian findings were detected in 160 women ( 12%). At the time of repeat sonogram there were 28 persisting abnormal ities (2%). At that time, the ovary was regarded as normal if it still contained a small clear cyst with an unchanged greatest dimension of less than 20 mm. Three women had a low PI value but all had also abnor mal ovarian sonographic morphology. Two ultrasound-guided cyst punctur es were performed and three patients had surgery; one benign serous cy st, one benign serous cystadenoma, and one serous cystadenoma of borde rline malignancy were detected. The remaining abnormal findings disapp eared or remained unchanged during a minimum follow-up of 2 years. One case of Stage IA ovarian cancer has been reported 2 years after a neg ative screening and one abdominal carcinomatosis 2 1/2 years after a n egative screening result.Conclusions. There is a high frequency of sma ll ovarian cysts in asymptomatic postmenopausal women. A large percent age of these cysts regress spontaneously or remain unchanged. Transvag inal color Doppler ultrasound is an effective method for detecting the se lesions. Color Doppler does not increase substantially the number o f operations for benign reasons. However, as a primary screening modal ity, the conventional sonography seems to be quite sufficient.