COMPARISON BETWEEN SONOGRAPHIC MORPHOLOGY AND DOPPLER WAVE-FORM FOR THE DIAGNOSIS OF OVARIAN MALIGNANCY

Objective: To assess the accuracy of pelvic sonography in distinguishi ng benign from malignant lesions in postmenopausal women, using morpho logic criteria and Doppler flow characteristics. Methods: All postmeno pausal patients scanned from March 1992 to April 1993 with sonographic ally identified and pathologically confirmed adnexal masses formed the study group. The adnexal lesions were morphologically categorized pro spectively as benign or malignant, and pulsed Doppler how studies were measured using the lowest resistance index obtained from each mass. T he sensitivity and specificity were determined for morphologic and Dop pler flow assessments, as well as for a combination Of these methods, for predicting the presence of malignancy. Results: Thirty-three postm enopausal patients formed the study group; 12 lesions were malignant a nd 21 were benign pathologically. Using morphologic criteria alone, th e sensi tivity in detecting malignancy was 91% and specificity was 52% . Using pulsed peppier alone with a resistance index limit of 0.6, the sensitivity in predicting malignancy was 66%, with a specificity of 8 1%. If a resistance index limit of 0.8 were used, the sensitivity and specificity would be the same as those for morphology alone. Combining morphology and resistance index, a single malignancy would still have been missed (sensitivity 91%). Conclusion: In our experience, Doppler flow studies did not add substantially to the prediction of malignanc y using morphologic assessment alone.