Transvaginal power Doppler findings in laparoscopically proven acute pelvic inflammatory disease

Objectives To evaluate the usefulness of power Doppler transvaginal sonogra phy (TVS) in the diagnosis of pelvic inflammatory disease (PID) and to asse ss the diagnostic reliability of specific sonographic findings. Population The study population consisted of 30 women admitted for suspecte d acute PID. The reference group consisted of 20 women with proven hydrosal pinx formation. Methods Both conventional TVS and power Doppler TVS were performed. All pat ients with suspected acute PID underwent laparoscopy in order to confirm th e diagnosis. Sonographic criteria described earlier were used for the diagn osis of acute PTD. Power Doppler was used to assess the vascularity of any adnexal mass. Results Laparoscopy confirmed the diagnosis of PID in 20 (67%) of the 30 wo men with clinically suspected acute PID. Specific TVS findings, including w all thickness > 5 mm, cogwheel sign, incomplete septa, and the presence of cul-de-sac fluid, discriminated women with acute PID from the control women with hydrosalpinx formation. Power Doppler TVS revealed hyperemia in all w omen with acute PID, but in only two women with hydrosalpinx (P = 0.01), Pu lsatility indices were significantly lower in the acute PID group than in t he control group (Pulsatility index 0.84 +/- 0.04 vs. 1.50 +/- 0.10;P < 0.0 1). Conclusion Power Doppler TVS was 100% sensitive and 80% specific in the dia gnosis of PTD (overall accuracy 93%). Specific sonographic landmark finding s and power Doppler findings augment the clinical diagnosis of PID and allo w simple classification of the severity of the disease.