COLOR-DOPPLER ULTRASOUND IN OVARIAN MASSES - ANATOMOPATHOLOGICAL CORRELATION

Background and aims: In the radiologic assessment of ovarian masses, t he major difficulty consists in the late recognition and lack of param eters for a differential diagnosis between benign and malignant lesion s, especially in the post-menopause when the incidence of cancer is hi gher. The use of a transvaginal probe and the color-Doppler examinatio n have recently improved the study of the female pelvis. This study is aimed to verify the possibility of the color-Doppler imaging to diffe rentiate between malignant and benign ovarian lesions during transvagi nal echographies, on the basis of the qualitative and quantitative cha racteristics of the vascular pattern of the ovarian lesions. Results: Twenty-six expansive ovarian lesions were studied: 8/26 showed no vasc ular signals and were considered benign as confirmed at histology. In the remaining lesions with some vascularization, the resistance index (RI) was evaluated; those with RI > 0.40 were considered benign, those with RI < 0.40 malignant. In 8/9 benign lesions and in 7/9 malignant neoplasms, the results of color-Doppler were coherent with histology. The results showed a sensibility of 87.5 % and a specificity of 88.8 % for the transvaginal examination. Conclusions: The main advantages of the color-Doppler transvaginal examination are: the high frequency of visualization of the ovaries, even in postmenopausal patients; the de finition of small lesions; the visualization of small parenchymal vess els, both physiologic and pathologic, and their quantitative analysis. The importance of the RI cutoff was critical for the differential dia gnosis between benign and malignant lesions: we think that a cutoff of 0.50, instead of 0.40 proposed by other authors, would be far more ap propriate.