Preoperative diagnosis of the primary Fallopian tube carcinoma by three-dimensional static and power Doppler sonography

Objective To investigate whether three-dimensional static and power Doppler ultrasound improves the diagnosis of primary Fallopian tube carcinoma. Methods During a 2-year period five cases of primary Fallopian tube carcino ma were selected from a cohort of 520 patients with a previous scan suggest ive of an adnexal tumor. Results Tubal malignancy occurred in patients between 49 and 64 years, with presenting symptoms stich as pain, vaginal bleeding and leukorrhea. CA 125 was elevated in three cases of tubal carcinoma with stages II and III, whi le in two patients with stage I, CA 125 was within the normal limits. Two-d imensional ultrasound demonstrated sausage shaped cystic masses with papill ary projections in two patients and a complex adnexal mass in one patient. Three-dimensional ultrasound revealed sausage shaped cystic and/or complex masses wish papillary projections in all five cases of tubal malignancy. In one patient preoperative 3-D ultrasound correctly predicted bilateral tumo rs, while 2-D transvaginal sonography found only unilateral changes. Additi onal 3-D power Doppler examination depicted vascular geometry typical for m alignant tumor vessels such as arteriovenous shunts, microaneurysms, tumora l lakes, blind ends and dichotomous branching in each of the cases with Fal lopian tube carcinoma. Conclusions Three-dimensional ultrasound allows precise depiction of tubal wall irregularities such as papillary protrusions and pseudosepta. Improved understanding of anatomical relationships may aid in distinguishing ovaria n from tubal pathology. Multiple sections of the tubal sausage like structu res enable determination of local tumor spread and capsule infiltration. St udy of the vascular architecture in cases of Fallopian tube malignancy is f urther enhanced using 3-D power Doppler imaging.