OVARIAN MASSES - CAN BENIGN AND MALIGNANT LESIONS BE DIFFERENTIATED WITH COLOR AND PULSED DOPPLER US

PURPOSE: To determine whether color and pulsed Doppler ultrasound (US) can be used to differentiate benign from malignant ovarian masses. MA TERIALS AND METHODS: Forty-four ovarian masses identified with sonogra phy in 40 patients were confirmed at surgery (n = 35) or followed up t o resolution with US (n = 9). Color and pulsed Doppler US were used to calculate the lowest pulsatility index (PI) and resistance index (RI) for each mass. RESULTS: Color Doppler US enabled detection of arteria l flow in 24 of 36 benign masses and six of eight malignant masses. PI was lower in malignant masses than in benign masses (P = .002), as wa s RI (P = .001). Both indexes demonstrated overlap between benign and malignant masses; therefore, no cutoff value for either index had both high sensitivity and high specificity for malignancy: For PI cutoff o f 1.0, sensitivity and specificity were 100% and 46%, respectively; fo r RI cutoff of 0.4, 50% and 96%. CONCLUSIONS: While PI and RI tend to be lower in malignant ovarian masses, neither index can be used reliab ly to differentiate benign from malignant lesions. In addition, lack o f detectable flow by means of color Doppler US does not exclude ovaria n malignancy.