TRANSVAGINAL COLOR DOPPLER SONOGRAPHY OF ADNEXAL MASSES - DIFFERENCESIN BLOOD-FLOW IMPEDANCE IN BENIGN AND MALIGNANT LESIONS

OBJECTIVE. The purpose of this study was to assess the blood flow char acteristics of adnexal masses before-surgical excision and to determin e whether color flow Doppler sonography is useful for distinguishing b enign from malignant masses. SUBJECTS AND METHODS. Thirty-one adnexal masses were evaluated with color flow Doppler transvaginal sonography. The pulsatility index and resistive index were calculated from the wa veforms generated from blood flow within the ovary. Twenty-five lesion s were benign and six were malignant on pathologic examination. Benign lesions included six endometriomas, six mesothelial cysts, three sero us and one mucinous cystadenoma, three mature cystic teratomas, two he morrhagic corpus luteum cysts, one cystadenofibroma, one sclerosing st romal cell tumor, one paratubal cyst, and one ovary that had undergone torsion with infarction. The malignant lesions consisted of three pap illary serous cystadenocarcinomas, one granulosatheca cell tumor, one immature teratoma, and one metastasis of colon cancer to the ovaries. RESULTS. Benign tumors and cysts had a significantly higher pulsatilit y index (mean, 1.93 +/- 1.02; range, 0.23-3.99) and resistive index (m ean, 0.77 +/- 0.22; range, 0.2-1.0) than did malignant tumors (pulsati lity index: mean, 0.77 +/- 0.33; range, 0.31-1.09; resistive index: me an, 0.5 +/- 0.17; range, 0.27-0.67). However, some overlap in individu al values for benign and malignant lesions was found. CONCLUSION. Our preliminary data suggest that high pulsatility and resistive indexes i ndicate benign adnexal processes; however, considerable overlap in pul satility and resistive indexes between benign and malignant lesions wa s noted, and further work is needed before the validity of these facto rs is proved.