Transvaginal ultrasonography associated with colour Doppler energy in the diagnosis of hydrosalpinx

The aims of this prospective study were to investigate the accuracy of B-mo de transvaginal ultrasonography alone, using the typical finding of the pre sence of an elongated shaped mass with incomplete septa, in the screening o f hydrosalpinx in women undergoing surgery for gynaecological diseases, and to determine the predictive value of this method combined with colour Dopp ler energy (CDE) imaging evaluation and CA125 concentrations in differentia ting hydrosalpinx from other adnexal masses. In the first part of the study , 378 consecutive pre-menopausal nonpregnant women were submitted to transv aginal ultrasonography alone before surgery. In the second part of the stud y, 256 adnexal masses underwent transvaginal ultrasonography combined with CDE imaging evaluation associated with spectral Doppler analysis and plasma concentrations of CA125, Sensitivity and specificity for the ultrasonograp hic screening were 84.6 and 99.7% respectively, calculated for each adnexum (n = 756) and 93.3 and 99.6% respectively, calculated for each mass, for d ifferentiating hydrosalpinx from other adnexal masses. The CDE imaging and the evaluation of CA125 plasma concentrations do not seem to increase the a ccuracy of B-mode transvaginal ultrasonography, Inter- and intraobserver ag reement, expressed in terms of k-values, was high (0.87 and 0.93 respective ly). In conclusion, transvaginal ultrasonography alone is a useful method o f detection of hydrosalpinx.