A COMBINED DOPPLER AND MORPHOPATHOLOGICAL STUDY OF OVARIAN-TUMORS

Objective: To evaluate intratumoral blood flow in 46 patients with ova rian masses. Methods: Transvaginal color Doppler was carried out in ea ch patient prior to the laparoscopy or laparotomy. Tumors were analyze d according to the size, morphology, presence of the neovascularizatio n, configuration and distribution of the tumoral blood vessels and pat tern of the intratumoral blood flow. Vascular patterns of surgically r emoved tumors were studied microscopically. Three types of vasculature were analyzed: neovascular capillaries without media, sinusoidal thin walled spaces and normal vessels' morphology. The RI (resistance inde x) values were analyzed in relation to gross appearance, histological type of the tumor, existence of in inflammation/necrosis area and vasc ularization pattern of the tumor. Results: Neovascularization was foun d in all the malignant tumors with low RI (less than 0.42) and solid o r solid cystic gross morphology. Neovascular signals were obtained in only one patient with ovarian endometrioma. Sinusoidal spaces were ide ntified in all the malignant ovarian tumors, but also in most of the b enign lesions. Normal vessel morphology was identified in 60% of malig nant ovarian tumors and in all the patients with benign ovarian lesion s. Conclusion: There is a significant correlation between Doppler and histopathological studies in terms of vascularization pattern analysis (detection of neovascular capillaries, sinusoidal spaces and normal V essels morphology). In most of the malignant ovarian tumors there were few areas of vascularization which can be analyzed non-invasively by transvaginal color and pulsed Doppler ultrasound. (C) 1997 Elsevier Sc ience Ireland Ltd.